术前老年营养风险指数对下消化道穿孔患者术后预后的影响

Effect of Preoperative Geriatric Nutritional Risk Index on Prognosis in Patients after Surgery for Lower Gastrointestinal Perforation.

作者信息

Hasegawa Makoto, Sanmoto Yohei

机构信息

Department of Surgery, Takeda General Hospital, Fukushima, Japan.

Department of Gastrointestinal Tract Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan.

出版信息

Ann Nutr Metab. 2024;80(6):323-330. doi: 10.1159/000541262. Epub 2024 Oct 4.

DOI:10.1159/000541262

PMID:39369711

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11614419/

Abstract

INTRODUCTION

Geriatric Nutritional Risk Index (GNRI) is a reliable index derived from serum albumin levels, height, and weight. Although various prognostic factors have been studied, the effect of preoperative nutritional status on surgical outcomes remains unexplored. This study aimed to evaluate the efficacy of the GNRI in predicting postoperative outcomes of lower gastrointestinal perforation.

METHODS

Eighty patients treated at our institution between January 2016 and December 2022 were retrospectively analyzed. This study primarily focused on the correlation between preoperative GNRI and two key outcomes: postoperative hospital stay duration and 1-year mortality rate.

RESULTS

Our findings revealed a significant association between low GNRI scores and increased 1-year mortality (odd ratio 4.0, 95% confidence interval [CI] 1.1-16, p = 0.025). Kaplan-Meier analysis and log-rank test showed that patients in the low GNRI group had markedly poorer overall survival rates than those in the high GNRI group (12-month survival rate 0.88 [95% CI: 0.75-0.95] vs. 0.65 [95% CI: 0.47-0.78]; p = 0.018). Additionally, both univariate and multivariate analyses indicated that lower GNRI scores were associated with prolonged hospital stays.

CONCLUSION

We showed that a low GNRI score was associated with high mortality and prolonged hospital stay after emergency surgery for lower gastrointestinal perforation.

摘要

引言

老年营养风险指数（GNRI）是一种基于血清白蛋白水平、身高和体重得出的可靠指标。尽管已经对各种预后因素进行了研究，但术前营养状况对手术结果的影响仍未得到探索。本研究旨在评估GNRI预测下消化道穿孔术后结果的有效性。

方法

回顾性分析了2016年1月至2022年12月在我院接受治疗的80例患者。本研究主要关注术前GNRI与两个关键结果之间的相关性：术后住院时间和1年死亡率。

结果

我们的研究结果显示，低GNRI评分与1年死亡率增加之间存在显著关联（比值比4.0，95%置信区间[CI]1.1 - 16，p = 0.025）。Kaplan-Meier分析和对数秩检验表明，低GNRI组患者的总体生存率明显低于高GNRI组（12个月生存率0.88[95%CI：0.75 - 0.95]对0.65[95%CI：0.47 - 0.78]；p = 0.018）。此外，单因素和多因素分析均表明，较低的GNRI评分与住院时间延长有关。