Inflammatory geriatric nutritional risk index stratified the survival of older adults with cancer sarcopenia

Preoperative nutritional status and postoperative health outcomes in older adults undergoing spine surgery: Electronic health records analysis

AIM

To examine whether a high nutritional risk status, assessed via the Geriatric Nutritional Risk Index (GNRI), is independently associated with postoperative health outcomes, including unplanned intensive care unit (ICU) admissions, infectious complications, and prolonged length of stay in older patients undergoing spine surgery.

METHODS

We conducted a retrospective descriptive study analyzing electronic health records from a tertiary hospital, including data from 1,014 patients aged ≥70 undergoing elective spine surgery between February 2013 and March 2023.

RESULTS

High nutritional risk patients had significantly higher odds of unplanned ICU admission, infectious complications, and prolonged length of stay compared to low-risk patients. For each one-point increase in GNRI, there was a significant 0.91- and 0.95-fold decrease in the odds of unplanned ICU admission and infectious complications, respectively.

CONCLUSION

GNRI screening in older patients before spine surgery may have potential to identify those at elevated risk for postoperative adverse outcomes.

The role of geriatric nutritional risk index as a predictor for postoperative outcomes in gastrointestinal emergencies

BACKGROUND

The geriatric nutritional risk index (GNRI) is a simple nutritional and inflammatory marker for older adults. The aim of the present study was to investigate the usefulness of the GNRI in older adults who underwent emergency gastrointestinal surgery.

METHODS

This study included 206 older adults who had undergone emergency gastrointestinal surgery. We retrospectively investigated the relationship between the GNRI and postoperative complications. Univariate and multivariate analyses were performed to evaluate risk factors for postoperative complications. We then evaluated the association between GNRI and clinical variables among older adults undergoing emergency gastrointestinal surgery.

RESULTS

Postoperatively, all complications occurred in 89 (43%) older adults, infectious in 53 (26%), and non-infectious in 36 (17%). In the multivariate analysis, age (p = 0.016), GNRI (p = 0.012), operative severity (p = 0.003), and operation time (p = 0.003) were independent risk factors for all postoperative complications. While the GNRI (p = 0.049) was an independent risk factor for infectious complications, age (p = 0.035) and bleeding volume (p = 0.035) were independent risk factors for postoperative non-infectious complications. In the low GNRI group, age (p = 0.029), serum C-reactive protein levels (p < 0.001), and proportion of sarcopenia (p < 0.001) were significantly higher, and the length of hospital stay (p < 0.001) was significantly longer than that in the high GNRI group. In Spearman's rank correlation coefficient, the skeletal mass index and the GNRI had a positive correlation (r = 0.415 and p < 0.001).

CONCLUSION

The GNRI may be a predictor of postoperative infectious complications in older adults after emergency gastrointestinal surgery, suggesting the usefulness of the GNRI as a nutritional marker and sarcopenia-related parameter.

TRIAL REGISTRATION NUMBER

No. 22-16.

Association between dietary knowledge and muscle mass in Chinese older adults: a cross-sectional and longitudinal study

OBJECTIVES

This study aims to explore the possible association between dietary knowledge and muscle mass in a Chinese population aged 60 years and above.

DESIGN

Cross-sectional and longitudinal studies.

SETTING

Data from the 2006 and 2011 China Health and Nutrition Survey (CHNS) were used for this study.

PARTICIPANTS

A total of 1487 Chinese participants (44.38% males) aged 60 and above in the 2006 survey were included in the cross-sectional study. From the same study population, a total of 1023 participants (46.82% males) with normal muscle mass on the interview date of 2006 were included in the longitudinal study.

OUTCOME MEASURES

Dietary knowledge was accessed by a validated CHNS questionnaire. Appendicular skeletal muscle mass was calculated using a validated anthropometric equation derived from a representative Chinese population. Based on the 2021 Chinese consensus on sarcopenia, the appendicular skeletal muscle mass was categorised as 'normal' or 'low' using sex-specific cut-off values.

RESULTS

The prevalence of low muscle mass in the study population was 31.20%, with a higher prevalence in females (34.22%). People with low muscle mass have a significantly lower dietary knowledge score (mean difference: -1.74, 95% CI -2.20 to -1.29). In the cross-sectional analysis, one score higher in dietary knowledge score was associated with a 4% lower odds of low muscle mass (OR=0.96, 95% CI 0.93 to 0.99). Compared with people in the lowest quartile of dietary knowledge, people in the highest quartile have a 44% lower odds of low muscle mass (OR=0.56, 95% CI 0.35 to 0.91). In the longitudinal analysis, no significant association was found between dietary knowledge and low muscle mass, yet the upper 95% CI was close to one (HR=0.97, 95% CI 0.93 to 1.01).

CONCLUSIONS

Sufficient dietary knowledge may play a protective role in maintaining normal muscle mass in Chinese adults aged 60 or above.