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Abstract：
UNASSIGNED: This study investigates the association between the Geriatric Nutritional Risk Index (GNRI), a measure of malnutrition risk, and 30-day postoperative complications following revision total hip arthroplasty (rTHA).
UNASSIGNED: The American College of Surgeons National Surgical Quality Improvement Program database was queried for all patients ≥65 who underwent aseptic rTHA between 2015 and 2021. The final study population (n = 7119) was divided into 3 groups based on preoperative GNRI: normal/reference (GNRI >98) (n = 4342), moderate malnutrition (92 ≤ GNRI ≤98) (n = 1367), and severe malnutrition (GNRI <92) (n = 1410). Multivariate logistic regression analysis was conducted to investigate the association between preoperative GNRI and 30-day postoperative complications.
UNASSIGNED: After controlling for significant covariates, the risk of experiencing any postoperative complications was significantly higher with both moderate (odds ratio [OR] 2.08, P < .001) and severe malnutrition (OR 8.79, P < .001). Specifically, moderate malnutrition was independently and significantly associated with deep vein thrombosis (OR 1.01, P = .044), blood transfusions (OR 1.78, P < .001), nonhome discharge (OR 1.83, P < .001), readmission (OR 1.27, P = .035), length of stay >2 days (OR 1.98, P < .001), and periprosthetic fracture (OR 1.54, P = .020). Severe malnutrition was independently and significantly associated with sepsis (OR 3.67, P < .001), septic shock (OR 3.75, P = .002), pneumonia (OR 2.73, P < .001), urinary tract infection (OR 2.04, P = .002), deep vein thrombosis (OR 1.01, P = .001), pulmonary embolism (OR 2.47, P = .019), acute renal failure (OR 8.44, P = .011), blood transfusions (OR 2.78, P < .001), surgical site infection (OR 2.59, P < .001), nonhome discharge (OR 3.36, P < .001), readmission (OR 1.69, P < .001), unplanned reoperation (OR 1.97, P < .001), length of stay >2 days (OR 5.41, P < .001), periprosthetic fractures (OR 1.61, P = .015), and mortality (OR 2.63, P < .001).
UNASSIGNED: Malnutrition has strong predictive value for short-term postoperative complications and has potential as an adjunctive risk stratification tool for geriatric patients undergoing rTHA.
UNASSIGNED: The American College of Surgeons National Surgical Quality Improvement Program database was queried for all patients ≥65 who underwent aseptic rTHA between 2015 and 2021. The final study population (n = 7119) was divided into 3 groups based on preoperative GNRI: normal/reference (GNRI >98) (n = 4342), moderate malnutrition (92 ≤ GNRI ≤98) (n = 1367), and severe malnutrition (GNRI <92) (n = 1410). Multivariate logistic regression analysis was conducted to investigate the association between preoperative GNRI and 30-day postoperative complications.
UNASSIGNED: After controlling for significant covariates, the risk of experiencing any postoperative complications was significantly higher with both moderate (odds ratio [OR] 2.08, P < .001) and severe malnutrition (OR 8.79, P < .001). Specifically, moderate malnutrition was independently and significantly associated with deep vein thrombosis (OR 1.01, P = .044), blood transfusions (OR 1.78, P < .001), nonhome discharge (OR 1.83, P < .001), readmission (OR 1.27, P = .035), length of stay >2 days (OR 1.98, P < .001), and periprosthetic fracture (OR 1.54, P = .020). Severe malnutrition was independently and significantly associated with sepsis (OR 3.67, P < .001), septic shock (OR 3.75, P = .002), pneumonia (OR 2.73, P < .001), urinary tract infection (OR 2.04, P = .002), deep vein thrombosis (OR 1.01, P = .001), pulmonary embolism (OR 2.47, P = .019), acute renal failure (OR 8.44, P = .011), blood transfusions (OR 2.78, P < .001), surgical site infection (OR 2.59, P < .001), nonhome discharge (OR 3.36, P < .001), readmission (OR 1.69, P < .001), unplanned reoperation (OR 1.97, P < .001), length of stay >2 days (OR 5.41, P < .001), periprosthetic fractures (OR 1.61, P = .015), and mortality (OR 2.63, P < .001).
UNASSIGNED: Malnutrition has strong predictive value for short-term postoperative complications and has potential as an adjunctive risk stratification tool for geriatric patients undergoing rTHA.
摘要：
■这项研究调查了老年营养风险指数(GNRI)之间的关联，衡量营养不良的风险，以及翻修全髋关节置换术（rTHA）后30天的术后并发症。
■美国外科医生学会国家外科质量改善计划数据库查询了2015年至2021年期间接受无菌rTHA的所有≥65的患者。最终研究人群（n=7119）根据术前GNRI分为3组：正常/参考（GNRI>98）（n=4342），中度营养不良（92≤GNRI≤98）（n=1367），严重营养不良（GNRI<92）（n=1410）。采用多因素logistic回归分析探讨术前GNRI与术后30d并发症的关系。
■在控制了显著的协变量后，中度营养不良(比值比[OR]2.08,P<.001)和重度营养不良(OR8.79,P<.001)患者发生任何术后并发症的风险均显著较高.具体来说,中度营养不良与深静脉血栓形成独立且显著相关(OR1.01,P=.044),输血（OR1.78，P<.001），非家庭放电（OR1.83，P<.001），再入院（OR1.27，P=.035），住院时间>2天（OR1.98，P<.001），和假体周围骨折（OR1.54，P=0.020）。严重营养不良与脓毒症独立且显著相关(OR3.67,P<.001),感染性休克（OR3.75，P=0.002），肺炎（OR2.73，P<.001），尿路感染（OR2.04，P=0.002），深静脉血栓形成（OR1.01，P=.001），肺栓塞（OR2.47，P=0.019），急性肾功能衰竭（OR8.44，P=.011），输血（OR2.78，P<.001），手术部位感染（OR2.59，P<.001），非家庭放电（OR3.36，P<.001），再入院（OR1.69，P<.001），计划外再操作（OR1.97，P<.001），住院时间>2天（OR5.41，P<.001），假体周围骨折（OR1.61，P=0.015），和死亡率（OR2.63，P<.001）。
■营养不良对短期术后并发症有很强的预测价值，并且有可能作为接受rTHA的老年患者的辅助风险分层工具。
■美国外科医生学会国家外科质量改善计划数据库查询了2015年至2021年期间接受无菌rTHA的所有≥65的患者。最终研究人群（n=7119）根据术前GNRI分为3组：正常/参考（GNRI>98）（n=4342），中度营养不良（92≤GNRI≤98）（n=1367），严重营养不良（GNRI<92）（n=1410）。采用多因素logistic回归分析探讨术前GNRI与术后30d并发症的关系。
■在控制了显著的协变量后，中度营养不良(比值比[OR]2.08,P<.001)和重度营养不良(OR8.79,P<.001)患者发生任何术后并发症的风险均显著较高.具体来说,中度营养不良与深静脉血栓形成独立且显著相关(OR1.01,P=.044),输血（OR1.78，P<.001），非家庭放电（OR1.83，P<.001），再入院（OR1.27，P=.035），住院时间>2天（OR1.98，P<.001），和假体周围骨折（OR1.54，P=0.020）。严重营养不良与脓毒症独立且显著相关(OR3.67,P<.001),感染性休克（OR3.75，P=0.002），肺炎（OR2.73，P<.001），尿路感染（OR2.04，P=0.002），深静脉血栓形成（OR1.01，P=.001），肺栓塞（OR2.47，P=0.019），急性肾功能衰竭（OR8.44，P=.011），输血（OR2.78，P<.001），手术部位感染（OR2.59，P<.001），非家庭放电（OR3.36，P<.001），再入院（OR1.69，P<.001），计划外再操作（OR1.97，P<.001），住院时间>2天（OR5.41，P<.001），假体周围骨折（OR1.61，P=0.015），和死亡率（OR2.63，P<.001）。
■营养不良对短期术后并发症有很强的预测价值，并且有可能作为接受rTHA的老年患者的辅助风险分层工具。
