Department of Spinal Surgery, the Affiliated Hospital of Qingdao University, No. 1677 Wutaishan Road, Qingdao, 266000, Shandong, China.
Department of Laboratory Medicine, the Affiliated Hospital of Qingdao University, No. 1677 Wutaishan Road, Qingdao, 266000, Shandong, China.
J Orthop Surg Res. 2024 Oct 15;19(1):659. doi: 10.1186/s13018-024-05167-z.
Malnutrition can lead to an increased risk of blood transfusion in elderly patients. The Geriatric Nutritional Risk Index (GNRI) is a tool used to assess nutritional status, but its predictive value for blood transfusion in elderly patients undergoing posterior lumbar interbody fusion (PLIF) is not well established. This study aimed to investigate the association between GNRI and the risk of perioperative blood transfusion in this population.
A retrospective cohort study was conducted on elderly patients aged 60 and above who underwent PLIF at Qingdao University Affiliated Hospital. Preoperative GNRI was calculated using height, weight, and serum albumin levels. The primary outcome was perioperative blood transfusion. Logistic regression analysis was performed, adjusting for potential confounders such as demographic characteristics, comorbidities, surgical factors, and laboratory tests.
A total of 1,246 elderly patients were included, with 144 (11.6%) requiring blood transfusion. After adjusting for all confounders, a lower GNRI was associated with a significantly higher risk of blood transfusion (OR = 2.4, 95% CI: 1.9-3.1, p < 0.001). Patients with a GNRI score below 92 had a significantly increased transfusion risk compared to those with normal GNRI scores (OR = 5.8, 95% CI: 3.7-9.1, p < 0.05). RCS analysis revealed a linear negative relationship between GNRI and transfusion risk.
The GNRI is a strong predictor of perioperative blood transfusion risk in elderly patients undergoing PLIF. Preoperative nutritional assessment using GNRI may help identify high-risk patients, enabling tailored interventions to optimize outcomes.
营养不良可导致老年患者输血风险增加。老年营养风险指数（GNRI）是一种用于评估营养状况的工具，但它对接受后路腰椎间融合术（PLIF）的老年患者输血风险的预测价值尚未得到充分证实。本研究旨在探讨 GNRI 与该人群围手术期输血风险之间的关系。
对在青岛大学附属医院接受 PLIF 的年龄在 60 岁及以上的老年患者进行回顾性队列研究。使用身高、体重和血清白蛋白水平计算术前 GNRI。主要结局是围手术期输血。对潜在混杂因素（如人口统计学特征、合并症、手术因素和实验室检查）进行调整后，采用 logistic 回归分析。
共纳入 1246 名老年患者，其中 144 名（11.6%）需要输血。调整所有混杂因素后，较低的 GNRI 与输血风险显著增加相关（OR=2.4，95%CI：1.9-3.1，p<0.001）。与 GNRI 评分正常的患者相比，GNRI 评分低于 92 的患者输血风险显著增加（OR=5.8，95%CI：3.7-9.1，p<0.05）。RCS 分析显示 GNRI 与输血风险之间呈线性负相关。
GNRI 是预测接受 PLIF 的老年患者围手术期输血风险的有力指标。使用 GNRI 进行术前营养评估可能有助于识别高风险患者，从而采取针对性干预措施优化结局。
