1.老年营养风险指数可预测骨质疏松性脊椎骨折患者的 90 天死亡率

Q3 Medicine North American Spine Society Journal Pub Date : 2024-07-01 DOI:10.1016/j.xnsj.2024.100339

Toshihiko Ito MD

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引用次数: 0

摘要

背景 CONTEX脆性骨折是老年患者的常见病，与高死亡率和功能性残疾有关。老年营养风险指数（GNRI）是预测住院患者死亡风险的客观营养状况评估工具。然而，老年营养风险指数是否能反映脆性骨折患者的短期死亡率尚不清楚。本研究旨在检查 GNRI 对脆性骨折患者营养状况的评估，并确定可预测死亡风险的临界分数。目的/研究设计/设定N/患者样本/结局测量N/方法回顾性研究了 2021 年至 2023 年我院的老年脆性骨折患者。共纳入 56 名患者（19 名男性，37 名女性，平均年龄（83.2 ± 6.7）岁）。所有患者均接受了 3 个月以上的随访。临床数据来自电子病历。对入院后 90 天内的死亡率进行了研究。所有患者入院时的 GNRI 计算公式为：14.89 × 血清白蛋白（g/dL）+ 41.7 × BMI / 22。结果平均 GNRI 为 97.2 ± 9.2 (76.6-114.7)。队列中有 3 人（5.2%）死亡；ROC-AUC 值为 0.85，GNRI 临界值为 95.6。结论我们的研究结果表明，使用 GNRI 评估营养状况有助于预测老年脆性骨折患者 90 天内的死亡率；GNRI 可被视为预测脆性骨折患者死亡风险的简单工具。此外，早期发现低营养状况可在骨折前改善营养状况，降低死亡风险。FDA 设备/药物状态本摘要不讨论或包含任何适用的设备或药物。

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1. Geriatric nutritional risk index can predict 90-day mortality in patients with osteoporotic vertebral fractures

BACKGROUND CONTEXT

Fragility fractures are common in elderly patients and are associated with high mortality and functional disability. The geriatric nutritional risk index (GNRI) is an objective nutritional status assessment tool to predict mortality risk in hospitalized patients. However, whether the GNRI reflects short-term mortality in fragility fracture patients is unclear. This study aimed to examine the nutritional status assessed by the GNRI in patients with fragility fractures and identify cut-off scores that predict mortality risk.

PURPOSE

N/A

STUDY DESIGN/SETTING

N/A

PATIENT SAMPLE

N/A

OUTCOME MEASURES

N/A

METHODS

Elderly fragility fracture patients in our hospital from 2021 to 2023 were retrospectively studied. A total of 56 patients (19 men and 37 women, mean age 83.2 ± 6.7 years) were included. All patients were followed up for more than 3 months. Clinical data were extracted from electronic medical records. Mortality within 90 days after admission was studied. GNRI was calculated for all patients on admission as 14.89 × serum albumin (g/dL) + 41.7 × BMI / 22. Using the recipient operating characteristic (ROC) curve, the area under the curve (AUC) that can predict mortality 90 days after admission and the optimal cut-off scores were calculated.

RESULTS

The mean GNRI was 97.2 ± 9.2 (76.6-114.7). Three (5.2%) deaths occurred in the cohort; the ROC-AUC value was 0.85, and the cut-off GNRI was 95.6. Sensitivity and specificity were 100% and 64.2%, respectively.

CONCLUSIONS

Our results show that nutritional status assessment using GNRI can help predict mortality within 90 days in elderly fragility fracture patients; GNRI can be considered a simple tool to predict mortality risk in fragility fracture patients. In addition, early detection of low nutritional status may improve nutritional status before fracture, reducing mortality risk.