PDF(Pubmed)
Abstract：
UNASSIGNED: Geriatric Nutritional Risk Index (GNRI) is a new and simple index recently introduced to assess nutritional status, and its predictive value for clinical outcomes has been demonstrated in patients with chronic kidney disease. However, the association between the GNRI and prognosis has not been evaluated so far in patients with acute kidney injury (AKI), especially in those receiving continuous renal replacement therapy (CRRT).
UNASSIGNED: A total of 1096 patients with severe AKI initiating CRRT were identified for inclusion in this retrospective observational study. Patients were divided into three groups according to GNRI tertiles, with tertile 1 as the reference. The outcomes of interest were the 28- and 90-days of all-cause mortality. The associations between GNRI and clinical outcomes were estimated using multivariate Cox proportional hazards model analysis.
UNASSIGNED: The overall mortality rates at 28- and 90-days were 61.6% (675/1096) and 71.5% (784/1096), respectively. After adjusting for multiple confounding factors, GNRI was identified as an independent prognostic factor for 28-days all-cause mortality (HR, 0.582; 95% CI, 0.467-0.727; p < .001 for tertile 3 vs. tertile 1) as well as 90-days all-cause mortality (HR, 0.540; 95% CI, 0.440-0.661; p < .001 for tertile 3 vs. tertile 1). The observed inverse associations were robust across subgroup analysis, and were more pronounced in elderly patients over 65 years of age. Finally, incorporating GNRI in a model with established risk factors might significantly improve its predictive power for the short-term death.
UNASSIGNED: GNRI is considered to be a useful prognostic factor in patients with severe AKI initiating CRRT, especially in elderly patients.
UNASSIGNED: A total of 1096 patients with severe AKI initiating CRRT were identified for inclusion in this retrospective observational study. Patients were divided into three groups according to GNRI tertiles, with tertile 1 as the reference. The outcomes of interest were the 28- and 90-days of all-cause mortality. The associations between GNRI and clinical outcomes were estimated using multivariate Cox proportional hazards model analysis.
UNASSIGNED: The overall mortality rates at 28- and 90-days were 61.6% (675/1096) and 71.5% (784/1096), respectively. After adjusting for multiple confounding factors, GNRI was identified as an independent prognostic factor for 28-days all-cause mortality (HR, 0.582; 95% CI, 0.467-0.727; p < .001 for tertile 3 vs. tertile 1) as well as 90-days all-cause mortality (HR, 0.540; 95% CI, 0.440-0.661; p < .001 for tertile 3 vs. tertile 1). The observed inverse associations were robust across subgroup analysis, and were more pronounced in elderly patients over 65 years of age. Finally, incorporating GNRI in a model with established risk factors might significantly improve its predictive power for the short-term death.
UNASSIGNED: GNRI is considered to be a useful prognostic factor in patients with severe AKI initiating CRRT, especially in elderly patients.
摘要：
■老年营养风险指数（GNRI）是最近引入的一种新的简单指标，用于评估营养状况，其对慢性肾脏病患者临床结局的预测价值已得到证实.然而,到目前为止，尚未在急性肾损伤（AKI）患者中评估GNRI与预后之间的关系，尤其是那些接受连续性肾脏替代治疗（CRRT）的患者。
■共有1096例严重AKI患者开始CRRT被纳入这项回顾性观察研究。根据GNRI三元率将患者分为三组，以1为参考。感兴趣的结果是全因死亡率的28天和90天。使用多变量Cox比例风险模型分析估计GNRI与临床结果之间的关联。
■28天和90天的总死亡率分别为61.6％（675/1096）和71.5％（784/1096），分别。在调整了多个混杂因素后，GNRI被确定为28天全因死亡率的独立预后因素(HR，0.582；95%CI，0.467-0.727；三分位数3与三元1)以及90天全因死亡率(HR，0.540；95%CI，0.440-0.661；三分位数3与p<.001Tertile1）。观察到的逆关联在亚组分析中是稳健的，在65岁以上的老年患者中更为明显。最后,将GNRI纳入具有既定风险因素的模型中,可能会显著提高其对短期死亡的预测能力.
■GNRI被认为是严重AKI患者开始CRRT的有用预后因素，尤其是老年患者。
■共有1096例严重AKI患者开始CRRT被纳入这项回顾性观察研究。根据GNRI三元率将患者分为三组，以1为参考。感兴趣的结果是全因死亡率的28天和90天。使用多变量Cox比例风险模型分析估计GNRI与临床结果之间的关联。
■28天和90天的总死亡率分别为61.6％（675/1096）和71.5％（784/1096），分别。在调整了多个混杂因素后，GNRI被确定为28天全因死亡率的独立预后因素(HR，0.582；95%CI，0.467-0.727；三分位数3与三元1)以及90天全因死亡率(HR，0.540；95%CI，0.440-0.661；三分位数3与p<.001Tertile1）。观察到的逆关联在亚组分析中是稳健的，在65岁以上的老年患者中更为明显。最后,将GNRI纳入具有既定风险因素的模型中,可能会显著提高其对短期死亡的预测能力.
■GNRI被认为是严重AKI患者开始CRRT的有用预后因素，尤其是老年患者。
