Zhao Yize, Huang Yong, Wang Zhe, Song Yueming, Chen Qian, Feng Ganjun
Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Orthopaedics, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.
Eur Spine J. 2025 May 27. doi: 10.1007/s00586-025-08957-z.
To investigate whether the Geriatric Nutrition Risk Index (GNRI) can serve as an independent predictor of postoperative urinary retention (PUR) in elderly patients undergoing transforaminal lumbar interbody fusion (TLIF).
This retrospective study reviewed elderly patients who underwent TLIF at a single institution between 2016 and 2021. Patients diagnosed with PUR during hospitalization were identified. GNRI was calculated based on body weight and preoperative serum albumin levels. Multivariate logistic regression analysis was used to determine the association between preoperative GNRI and PUR. Receiver operating characteristic (ROC) curve analysis was conducted to determine the optimal GNRI cutoff value for predicting PUR.
A total of 294 patients met the inclusion criteria. PUR occurred in 47 patients (15.9%). The GNRI was significantly lower in the PUR group compared to the non-PUR group (93.3 ± 7.49 vs. 101.6 ± 6.59, P < 0.001). Multivariate logistic regression analysis confirmed that a lower GNRI independently predicted PUR (OR: 0.763; 95% CI: 0.699-0.834, p < 0.001). ROC analysis identified a GNRI cutoff value of 94.7, with an area under the curve (AUC) of 0.799 ± 0.037.
Lower GNRI is significantly associated with increased risk of PUR following TLIF. GNRI may serve as a useful, independent predictor of PUR risk.
探讨老年营养风险指数（GNRI）能否作为老年患者经椎间孔腰椎椎间融合术（TLIF）术后尿潴留（PUR）的独立预测指标。
这项回顾性研究纳入了2016年至2021年在单一机构接受TLIF手术的老年患者。确定住院期间被诊断为PUR的患者。根据体重和术前血清白蛋白水平计算GNRI。采用多因素logistic回归分析确定术前GNRI与PUR之间的关联。进行受试者工作特征（ROC）曲线分析以确定预测PUR的最佳GNRI临界值。
共有294例患者符合纳入标准。47例患者（15.9%）发生PUR。与非PUR组相比，PUR组的GNRI显著更低（93.3±7.49 vs. 101.6±6.59，P<0.001）。多因素logistic回归分析证实，较低的GNRI可独立预测PUR（OR：0.763；95%CI：0.699-0.834，p<0.001）。ROC分析确定GNRI临界值为94.7，曲线下面积（AUC）为0.799±0.037。
较低的GNRI与TLIF术后PUR风险增加显著相关。GNRI可能是预测PUR风险的一个有用的独立指标。
