METHODS: The study involved geriatric burn patients (aged ≥ 65 y) who underwent burn surgery between 2012 and 2022. The GNRI was computed using the following formula: 1.489 × serum albumin concentration (mg/L) + 41.7 × patient body weight/ideal body weight. Patients were dichotomized into the high GNRI (≥ 82) and low GNRI (< 82) groups. GNRI was evaluated as an independent predictor of 30-d postoperative mortality. The study also evaluated the association between GNRI and sepsis, the need for continuous renal replacement therapy (CRRT), major adverse cardiac events (MACE), and pneumonia.
RESULTS: Out of 270 patients, 128 (47.4%) had low GNRI (< 82). Multivariate Cox regression analysis revealed that low GNRI was significantly associated with 30-d postoperative mortality (hazard ratio: 1.874, 95% confidence interval [CI]: 1.146-3.066, P = 0.001). Kaplan-Meier analysis revealed that the 30-day mortality rate differed significantly between the low and high GNRI groups (log-rank test, P < 0.001). The 30-d postoperative mortality (hazard ratio: 2.677, 95% CI: 1.536-4.667, P < 0.001) and the incidence of sepsis (odds ratio [OR]: 2.137, 95% CI: 1.307-3.494, P = 0.004), need for CRRT (OR: 1.919, 95% CI: 1.101-3.344, P = 0.025), MACE (OR: 1.680, 95% CI: 1.018-2.773, P = 0.043), and pneumonia (OR: 1.678, 95% CI: 1.019-2.764, P = 0.044), were significantly higher in the low GNRI group than in the high GNRI group.
CONCLUSIONS: Preoperative low GNRI was associated with increased 30-d postoperative mortality, sepsis, need for CRRT, MACE, and pneumonia in geriatric burn patients.
方法:该研究涉及2012年至2022年期间接受烧伤手术的老年烧伤患者(年龄≥65岁)。使用以下公式计算GNRI:1.489×血清白蛋白浓度(mg/L)+41.7×患者体重/理想体重。将患者分为高GNRI(≥82)和低GNRI(<82)组。GNRI被评估为术后30天死亡率的独立预测因子。该研究还评估了GNRI与脓毒症之间的关联,持续肾脏替代疗法(CRRT)的需要,主要不良心脏事件(MACE),和肺炎。
结果:在270名患者中,128(47.4%)的GNRI较低(<82)。多因素Cox回归分析显示,低GNRI与术后30d死亡率显著相关(风险比:1.874,95%置信区间[CI]:1.146-3.066,P=0.001)。Kaplan-Meier分析显示,低GNRI组和高GNRI组之间的30天死亡率差异显着(log-rank检验,P<0.001)。术后30d死亡率(风险比:2.677,95%CI:1.536-4.667,P<0.001)和败血症发生率(比值比[OR]:2.137,95%CI:1.307-3.494,P=0.004),需要CRRT(OR:1.919,95%CI:1.101-3.344,P=0.025),MACE(OR:1.680,95%CI:1.018-2.773,P=0.043),和肺炎(OR:1.678,95%CI:1.019-2.764,P=0.044),低GNRI组显著高于高GNRI组。
结论:术前低GNRI与术后30天死亡率增加相关,脓毒症,需要CRRT,MACE,老年烧伤患者的肺炎。