Abstract：
BACKGROUND: The geriatric nutritional risk index (GNRI) can easily identify malnutrition-associated morbidity and mortality. We investigated the association between preoperative GNRI and 30-d mortality in geriatric burn patients who underwent surgery.
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.
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.
摘要：
背景：老年营养风险指数（GNRI）可以很容易地确定营养不良相关的发病率和死亡率。我们调查了接受手术的老年烧伤患者术前GNRI与30d死亡率之间的关系。
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。
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。
