Geriatric nutritional risk index serves as risk factor of surgical site infection after pancreatoduodenectomy: a validation cohort Ageo study

Funamizu, Naotake; Omura, Kenji; Ozaki, Takahiro; Honda, Masaaki; Mishima, Kazuo; Igarashi, Kento; Takada, Yasutsugu; Wakabayashi, Go

doi:10.21037/gs-20-451

Cited by 18 publications

(16 citation statements)

References 30 publications

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“…For example, several studies indicated that albumin was a significant risk factor for hospital‐acquired pneumonia (Dziedzic et al., 2006 ; Yang et al., 2020 ). Besides, another study found that GNRI was a risk factor for surgical site infection after pancreaticoduodenectomy (Funamizu et al., 2020 ). In the present study, GNRI was an independent risk factor for SAP in AIS patients.…”

Section: Discussionmentioning

confidence: 99%

Geriatric Nutritional Risk Index is related to the risk of stroke‐associated pneumonia

Dai

Duan

et al. 2022

Brain and Behavior

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Background Stroke‐associated pneumonia (SAP) occurs frequently after a stroke. Geriatric Nutritional Risk Index (GNRI) is a valuable indicator of elderly individuals’ nutritional status. This research was designed to obtain insight into the link between GNRI and SAP. Methods Patients with acute ischemic stroke (AIS) were categorized into the SAP and non‐SAP groups. GNRI scores were divided into four layers: Q1, GNRI < 82; Q2, 82≤ GNRI < 92; Q3, 92≤ GNRI ≤98; Q4, GNRI > 98. To identify the independent risk and protective factors of developing SAP, logistic regression analyses were conducted. Additionally, we utilized the restricted cubic spline (RCS) analysis to test the effect of GNRI on the SAP risk. Results The SAP group showed lower GNRI scores than the non‐SAP group (96.88 ± 9.36 vs. 100.88 ± 8.25, p < 0.001). According to the logistic regression model, the Q1 and Q2 layers showed a higher risk of SAP than the Q3 layer, while the Q4 layer showed a lower SAP risk (all p < 0.05). Besides, the RCS model found that the risk of SAP dropped dramatically as GNRI scores increased, which got stable when the GNRI score was more significant than 100. Conclusion Lower GNRI scores were linked to a higher prevalence of SAP. In clinical practice, GNRI showed predictive value for SAP, which could be helpful in early SAP intervention and therapy.

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Section: Discussionmentioning

confidence: 99%

Geriatric Nutritional Risk Index is related to the risk of stroke‐associated pneumonia

Dai

Duan

et al. 2022

Brain and Behavior

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“…The GNRI score is a simple scale system initially designed to assess malnutrition risk among elderly patients ( 22 ). Subsequently, the GNRI score was applied to predict sepsis mortality ( 32 ) and the probability of surgical site infections ( 33 , 34 ). Malnutrition risk was found in 5.3% of 8,698 Chinese patients with AIS according to the GNRI score ( 35 ).…”

Section: Discussionmentioning

confidence: 99%

A nomogram based on nutritional status and A2DS2 score for predicting stroke-associated pneumonia in acute ischemic stroke patients with type 2 diabetes mellitus: A retrospective study

Song

Bai

et al. 2022

Front. Nutr.

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BackgroundStroke-associated pneumonia (SAP) commonly complicates acute ischemic stroke (AIS) and significantly worsens outcomes. Type 2 diabetes mellitus (T2DM) may contribute to malnutrition, impair innate immunity function, and increase the probability of SAP occurrence in AIS patients. We aimed to determine early predictors of SAP in AIS patients with T2DM and to construct a nomogram specifically for predicting SAP in this population by combining the A2DS2 score with available nutrition-related parameters.MethodsA total of 1,330 consecutive AIS patients with T2DM were retrospectively recruited. The patients were randomly allocated to the training (n = 887) and validation groups (n = 443). Univariate and multivariate binary logistic regression analyses were applied to determine the predictors of SAP in the training group. A nomogram was established according to the identified predictors. The areas under the receiver operating characteristic curve (AUROC) and calibration plots were performed to access the predictive values of the nomogram. The decision curve was applied to evaluate the net benefits of the nomogram.ResultsThe incidence of SAP was 9% and 9.7% in the training and validation groups, respectively. The results revealed that the A2DS2 score, stroke classification, Geriatric Nutritional Risk Index, hemoglobin, and fast blood glucose were independent predictors for SAP. A novel nomogram, A2DS2-Nutrition, was constructed based on these five predictors. The AUROC for A2DS2-Nutrition (0.820, 95% CI: 0.794–0.845) was higher than the A2DS2 score (0.691, 95% CI: 0.660–0.722) in the training group. Similarly, it showed a better predictive performance than the A2DS2 score [AUROC = 0.864 (95% CI: 0.828–0.894) vs. AUROC = 0.763 (95% CI: 0.720–0.801)] in the validation group. These results were well calibrated in the two groups. Moreover, the decision curve revealed that the A2DS2-Nutrition provided an additional net benefit to the AIS patients with T2DM compared to the A2DS2 score in both groups.ConclusionThe A2DS2 score, stroke classification, Geriatric Nutritional Risk Index, hemoglobin, and fast blood glucose were independent predictors for SAP in AIS patients with T2DM. Thus, the proposed A2DS2-Nutrition may be a simple and reliable prediction model for SAP occurrence in AIS patients with T2DM.

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“…has reported that a lower GNRI score was independently associated with an increased risk of infection-associated mortality in patients receiving hemodialysis [27]. Other studies have also demonstrated that a poor nutritional status indicated by a lower GNRI score was also associated with an increased risk of surgical site infection after pancreatoduodenectomy and soft tissue sarcoma resection, while the infection risk could be effectively reduced with nutritional intervention during the perioperative period [28,29]. Likewise, we have reported a signi cant association between a lower GNRI score and a higher risk of invasive candidiasis.…”

Section: Discussionmentioning

confidence: 99%

Association between Geriatric Nutritional Risk Index and Invasive Candidiasis in Critical Care

Chen

et al. 2022

Preprint

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Background Invasive candidiasis is a common infectious complication in geriatric critical care patients, which is thought to be related to malnutrition. The geriatric nutritional risk index (GNRI) score is an integrative and convenient tool to dynamically and comprehensively assess a patient’s current nutritional status. Thus, this study aims to assess the association between GNRI scores and invasive candidiasis in geriatric critical care patients. Methods A total of 5390 patients from the MIMIC-IV database were included in the training cohort to develop disease prediction models by logistic regression, Gradient Boosting Machine (GBM), eXtreme Gradient Boosting (XGBoost), Light Gradient Boosting Machine (LightGBM), and Random Forest (Rf) model. Developed models were validated in the test cohort consisting of 2766 patients from the MIMIC-III database. The area under the receiver operating curve (AUC) is used to represent the predictive performance of the different models. Results A decreased GNRI was significantly associated with invasive candidiasis in geriatric critical care patients (P < 0.001). The AUCs for the Rf model and GBM model were not significantly different than that of the logistic regression model (0.7093 versus 0.683; P = 0.4562; 0.6874 versus 0.683; P = 0.9178) in test cohort. The AUCs for the XGBoost model and LightGBM model were significantly lower than that of the logistic regression model (0.511 versus 0.683; P < 0.001; 0.6874 versus 0.592; P < 0.001) in the test cohort. Further analysis showed that GNRI as a continuous variable rather than a categorical variable is more valuable for predicting invasive candidiasis in our cohort. Conclusion Lower GNRI score was significantly associated with an increased risk of invasive candidiasis in geriatric ICU patients. Machine learning, particularly the GBM model and Rf model, can help in the prediction of invasive candidiasis.

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Geriatric nutritional risk index serves as risk factor of surgical site infection after pancreatoduodenectomy: a validation cohort Ageo study

Cited by 18 publications

References 30 publications

Geriatric Nutritional Risk Index is related to the risk of stroke‐associated pneumonia

Geriatric Nutritional Risk Index is related to the risk of stroke‐associated pneumonia

A nomogram based on nutritional status and A2DS2 score for predicting stroke-associated pneumonia in acute ischemic stroke patients with type 2 diabetes mellitus: A retrospective study

Association between Geriatric Nutritional Risk Index and Invasive Candidiasis in Critical Care

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