Geriatric nutritional risk index as the prognostic factor in older patients with fragility hip fractures

Tsutsui, Tomoko; Fujiwara, Toshifumi; Matsumoto, Yoshihiro; Kimura, Atsushi; Kanahori, Masaya; Arisumi, Shinkichi; Oyamada, Akiko; Ohishi, Masanobu; Ikuta, Kentaro; Tsuchiya, Kuniyoshi; Tayama, Naohisa; Tomari, Shinji; Miyahara, Hisaaki; Mae, Takao; Hara, Toshihiko; Saito, Taichi; Arizono, Takeshi; Kaji, Koichi; Mawatari, Taro; Fujiwara, Masami; Takasaki, M.; Shin, Kunichika; Ninomiya, Kenta; Nakaie, Kazutoshi; Antoku, Yasuaki; Iwamoto, Yukihide; Nakashima, Yasuharu

doi:10.1007/s00198-023-06753-3

Cited by 10 publications

(5 citation statements)

References 67 publications

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“…The Geriatric Nutritional Risk Index (GNRI), which correlates with Body Mass Index (BMI) and serum albumin levels, has garnered recognition as a significant prognostic indicator across various medical conditions. These indicators are not only readily attainable but also cost-effective [ 44 ]. Within the context of systemic inflammatory responses, pro-inflammatory cytokines and growth factors exert catabolic effects that contribute to muscle breakdown.…”

Section: Discussionmentioning

confidence: 99%

Combined Systemic Immune-inflammatory Index (SII) and Geriatric Nutritional Risk Index (GNRI) predict survival in elderly patients with hip fractures: a retrospective study

Zhou,

Huang,

Zhu

et al. 2024

J Orthop Surg Res

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Purpose The Systemic Immune-inflammatory Index (SII) and Geriatric Nutritional Risk Index (GNRI) have undergone comprehensive examination and validation in forecasting the outcomes of diverse medical conditions. Nevertheless, the correlation between the combined use of GNRI and SII metrics and hip fractures has yet to be elucidated. This study aimed to determine whether the amalgamation of SII and GNRI scores constitutes an independent prognostic factor for elderly patients with hip fractures. Methods We conducted a retrospective analysis of elderly patients admitted to our facility with hip fractures, encompassing both femoral neck and intertrochanteric fractures. Demographic information, experimental parameters, and postoperative complications were systematically recorded. The Geriatric Nutritional Risk Index (GNRI) and Systemic Immunoinflammatory Index (SII) were meticulously computed. Receiver operating characteristic (ROC) curves were generated, and optimal cutoff values for each parameter were determined. Subsequently, a multivariate Cox regression analysis was employed to assess the predictive utility of the SII–GNRI score in relation to 1-year postoperative mortality among elderly patients with hip fractures. Results In a study involving 597 patients, 90 of whom experienced mortality within 1 year, it was observed that the SII-GNRI score in the group of patients who passed away was significantly higher compared to the group that survived. Following a multifactorial adjustment, it was established that a high SII–GNRI score served as an independent predictor of 1-year all-cause mortality in older patients with hip fractures. In addition to the SII–GNRI score, factors such as length of hospital stay, CCI > 2, and blood transfusion were also identified as independent risk factors for survival. Notably, the incidence of postoperative complications in patients with high SII–GNRI scores was significantly greater than in patients with low scores. Conclusion The SII–GNRI score proves valuable in predicting the 1-year survival rate for elderly patients with hip fractures who have undergone surgery.

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Section: Discussionmentioning

confidence: 99%

Combined Systemic Immune-inflammatory Index (SII) and Geriatric Nutritional Risk Index (GNRI) predict survival in elderly patients with hip fractures: a retrospective study

Zhou,

Huang,

Zhu

et al. 2024

J Orthop Surg Res

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“…Contrary to our ndings, Nakamura T et al 16 demonstrated a higher incidence of adverse events in male heart failure patients with low GNRI compared to female patients. A study on brittle hip fractures in the elderly identi ed older age, male gender, lower GNRI score, comorbidities, and lower BI as primary risk factors 17 . Interestingly, our study diverges from these results, as women emerged as predictors of poor prognosis, linked to poorer short-term postoperative outcomes in various cardiovascular surgical procedures 18 .…”

Section: Discussionmentioning

confidence: 99%

The Geriatric Nutritional Risk Index is related to adverse hospitalization outcomes in individuals undergoing cardiac surgery

Zhao,

Li,

Liao

et al. 2024

Preprint

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Malnutrition is linked to adverse outcomes in post-cardiac surgery patients. This study investigates the correlation between GNRI and adverse hospital outcomes in patients following cardiac surgery. This retrospective study included elderly patients with heart disease who were admitted to the Department of Cardiology, Union Hospital Affiliated to Fujian Medical University from January 2020 to December 2022. Patients were divided into two groups based on the cut-off value (98g/dL). Data from 407 patients were assessed, with 278 (68.3%) classified as having nutritional risk and 129 (31.7%) as having no nutritional risk. Notable distinctions were observed in body weight, BMI, and left ventricular ejection fraction (P < 0.05). Laboratory indicators indicated lower levels of serum albumin, lymphocytes, red blood cells, hemoglobin, admission blood glucose, and admission triglyceride in the nutritional risk group (P < 0.05). Neutrophils and serum creatinine were higher in the nutritional risk group (P < 0.05). Poor prognosis was prevalent in the nutrition risk group (64.7%), with higher incidences of adverse outcomes (P < 0.05). Univariate and multivariate studies showed that GNRI < 98 was an independent predictor of postoperative cardiac surgery. Nutritional risk was an important predictor of postoperative adverse hospital outcomes.

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“…Our results are consistent with those of two prior meta-analyses, which found that being at risk of malnutrition and malnourished nutritional status according to MNA were both significantly associated with higher total mortality [17,81], and that patients with low GNRI or low MNA-SF scores had a significantly higher risk of mortality compared to those with higher scores. Other studies included in the systematic review found a significant correlation between nutritional status and mortality from a qualitative point of view: at risk of malnutrition/malnourished status is negatively correlated with 3, 6, and 12 months mortality according to MNA [48], and with 6 months mortality according to CONUT score [50] and GNRI [59,71].…”

Section: Mortalitymentioning

confidence: 97%

“…At the end of the selection process, 36 studies were eligible for inclusion in the systematic review [25,28,30,31,33,34,36,[38][39][40][41][43][44][45][46][48][49][50][51]53,54,56,[58][59][60][61]64,[67][68][69][70][71][72][73]75,76] and 14 studies were eligible for inclusion in the meta-analysis [34,36,39,43,49,51,53,56,64,[67][68][69][70]72].…”

Section: Study Selectionmentioning

confidence: 99%

Malnutrition-Related Health Outcomes in Older Adults with Hip Fractures: A Systematic Review and Meta-Analysis

Chiavarini,

Ricciotti,

Genga

et al. 2024

Nutrients

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Hip fracture is a common condition in older adults, leading to disability and mortality. Several studies have demonstrated the association between nutritional status and the risk of a negative health outcome after fractures. In this systematic review, we evaluated the association between malnutrition and mortality, changes in mobility/living arrangements, and postoperative complications, such as delirium, in older patients with hip fractures. A literature search on the PubMed, Web of Science, and Scopus databases, up to September 2023, was conducted to identify all studies involving older subjects that reported an association between MNA/GNRI/PNI/CONUT and health outcome after hip fracture. Meta-analysis was performed by a random-effects model using risk values (RR, OR, and HR) extracted from the 14 eligible selected studies. Malnutrition significantly increased the risk of any analyzed adverse outcome by 70% at 1 month, and up to 250% at 1 year. Malnutrition significantly increased delirium risk by 275% (OR = 2.75; 95% CI 1.80–4.18; p ≤ 0.05), mortality risk by 342% (OR = 3.42; 95% CI 2.14–5.48; p ≤ 0.05), mortality hazard risk by 351% (HR = 3.51; 95% CI 1.63–7.55; p ≤ 0.05) at 1 month, and transfer-to-more-supported-living-arrangements risk by 218% (OR = 2.18; 95% CI 1.58–3.01; p ≤ 0.05), and declined mobility risk by 41% (OR = 1.41; 95% CI 1.14–1.75; p ≤ 0.05), mortality risk by 368% (OR = 3.68; 95% CI 3.00–4.52; p ≤ 0.05), and mortality hazard risk by 234% (HR = 2.34; 95% CI 1.91–2.87; p ≤ 0.05) at 1 year. Malnutrition of older patients increases the risk of death and worsens mobility and independence after hip fractures. The results of the present study highlight the importance of nutritional status evaluation of older subjects with hip fractures in order to prevent potential adverse outcomes (Registration No: CRD42023468751).

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Geriatric nutritional risk index as the prognostic factor in older patients with fragility hip fractures

Cited by 10 publications

References 67 publications

Combined Systemic Immune-inflammatory Index (SII) and Geriatric Nutritional Risk Index (GNRI) predict survival in elderly patients with hip fractures: a retrospective study

Combined Systemic Immune-inflammatory Index (SII) and Geriatric Nutritional Risk Index (GNRI) predict survival in elderly patients with hip fractures: a retrospective study

The Geriatric Nutritional Risk Index is related to adverse hospitalization outcomes in individuals undergoing cardiac surgery

Malnutrition-Related Health Outcomes in Older Adults with Hip Fractures: A Systematic Review and Meta-Analysis

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