Lin Lingyu, Li Sailan, Peng Yanchun, Pan Qiong, Hong Ni, Chen Liangwan, Lin Yanjuan
Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian Province, China.
Heart Center of Fujian Medical University, Fuzhou, 350001, Fujian Province, China.
BMC Cardiovasc Disord. 2025 Aug 2;25(1):572. doi: 10.1186/s12872-025-05045-4.
The impact of the geriatric nutritional risk index (GNRI) on the prognosis of patients with acute Stanford type A aortic dissection (AAAD) remains unclear. This study sought to explore the predictive value of GNRI for in-hospital mortality in patients with AAAD.
We conducted a retrospective analysis of patients who underwent surgery for AAAD from January 2014 to December 2022. Based on the median GNRI score, patients were stratified into high GNRI (> 103.7) and low GNRI (≤ 103.7) groups. Multivariate logistic regression analysis was used to assess the association between GNRI and in-hospital mortality.
A total of 936 patients were included, with a mean age of 52.7 ± 11.6 years. The mean GNRI was 103.8 ± 11.3, and patients were stratified into low GNRI (n = 472, 50.4%) and high GNRI (n = 464, 49.6%) groups. The low GNRI group had a significantly higher in-hospital mortality rate than the high GNRI group (23.1% vs. 17.5%, P = 0.032). Multivariate logistic regression identified GNRI ≤ 103.7 as an independent risk factor for in-hospital mortality (OR = 2.037, 95%CI:1.110-3.740, P = 0.022). CPB time (OR = 1.005, 95%CI: 1.001-1.009, P = 0.022), and lactate levels (OR = 1.221, 95%CI: 1.144-1.302, P < 0.001) were also independent risk factors for in-hospital mortality. The AUC of the logistic model was 0.811.
The GNRI is a validated nutritional assessment tool, and AAAD patients with a GNRI ≤ 103.7 havesignificantly higher in-hospital mortality rate. These findings highlight the importance of preoperative nutritional assessment and optimization to improve outcomes for AAAD patients.
老年营养风险指数（GNRI）对急性A型主动脉夹层（AAAD）患者预后的影响尚不清楚。本研究旨在探讨GNRI对AAAD患者院内死亡率的预测价值。
我们对2014年1月至2022年12月接受AAAD手术的患者进行了回顾性分析。根据GNRI评分中位数，将患者分为高GNRI（>103.7）和低GNRI（≤103.7）组。采用多因素logistic回归分析评估GNRI与院内死亡率之间的关联。
共纳入936例患者，平均年龄52.7±11.6岁。平均GNRI为103.8±11.3，患者分为低GNRI组（n = 472，50.4%）和高GNRI组（n = 464，49.6%）。低GNRI组的院内死亡率显著高于高GNRI组（23.1%对17.5%，P = 0.032）。多因素logistic回归分析确定GNRI≤103.7是院内死亡的独立危险因素（OR = 2.037，95%CI：1.110 - 3.740，P = 0.022）。体外循环时间（OR = 1.005，95%CI：1.001 - 1.009，P = 0.022）和乳酸水平（OR = 1.221，95%CI：1.144 - 1.302，P < 0.001）也是院内死亡的独立危险因素。logistic模型的AUC为0.811。
GNRI是一种经过验证的营养评估工具，GNRI≤103.7的AAAD患者院内死亡率显著更高。这些发现凸显了术前营养评估和优化对改善AAAD患者预后的重要性。
