Correlation of Nutritional Indices on Admission to the Coronary Intensive Care Unit with the Development of Delirium

Sugita, Yurina; Miyazaki, Tatsuya; Shimada, Kazunori; Shimizu, Megumi; Kunimoto, Mitsuhiro; Ouchi, Shohei; Aikawa, Tatsuro; Kadoguchi, Tomoyasu; Kawaguchi, Yuko; Shiozawa, Tomoyuki; Takasu, Kiyoshi; Hiki, Masaru; Takahashi, Shuhei; Sumiyoshi, Katsuhiko; Iwata, Hiroshi; Daida, Hiroyuki

doi:10.3390/nu10111712

Cited by 20 publications

(14 citation statements)

References 34 publications

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“…According to the present results, the MNA-SF outperformed GNRI in predicting POD among elderly noncardiac surgical patients. To date, only one study by Sugita, et al compared different screening tools, including the GNRI, PNI and CONUT, for prediction of delirium in coronary intensive care unit patients and they observed no a significant association between GNRI and delirium [36], which is similar to our study. Recently, Chu et al and Mazzola et al used the MNA-SF as a screening tool among orthopedic surgical patients and detected a significant association between MNA-SF and POD [31,37].…”

Section: Discussionsupporting

confidence: 90%

The geriatric nutrition risk index versus the mini-nutritional assessment short form in predicting postoperative delirium and hospital length of stay among older non-cardiac surgical patients: a prospective cohort study

Zhao

Xie

et al. 2020

BMC Geriatr

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Backgrounds: Malnutrition has been shown to be associated with poor prognosis in older surgical patients. Several tools are available for detecting malnutrition. But little is known about their ability to assess risks of postoperative adverse outcomes. The study aimed to compare the ability of the Geriatric Nutritional Risk Index (GNRI) and the Mini-Nutritional Assessment Short Form (MNA-SF) in predicting postoperative delirium (POD) and length of stay (LOS) among older non-cardiac surgical patients. Methods: Prospective study of 288 older non-cardiac surgical patients from the West China Hospital of Sichuan University. Preoperative nutritional status was assessed using the GNRI and MNA-SF, and patients were followed for the occurrence of POD and LOS. Multivariable logistic regression and linear regression analyses were used to identify predictors of these outcomes. The relative performance of the GNRI and MNA-SF as predictors of these outcomes were determined by Receiver Operating Characteristic curves (ROC) analyses and the area under the curve (AUC). Results: Multivariable analysis revealed that preoperative malnutrition by the MNA-SF was significantly associated with POD. Linear regression analysis showed that preoperative low/high nutritional risk of the GNRI and malnutrition by the MNA-SF were independent predictors of prolonged LOS. Moreover, the area under the curve (AUC) of MNA-SF scores for POD was better than GNRI scores (AUC = 0.

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Section: Discussionsupporting

confidence: 90%

The geriatric nutrition risk index versus the mini-nutritional assessment short form in predicting postoperative delirium and hospital length of stay among older non-cardiac surgical patients: a prospective cohort study

Zhao

Xie

et al. 2020

BMC Geriatr

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“…To date, only one study by Sugita, et al compared different screening tools, including the GNRI, PNI and CONUT, for prediction of delirium in coronary intensive care unit patients. Unlike our study, they failed to find a significant association between GNRI and delirium (34). The difference may be related to the fact that the incidence of delirium (17%) detected in our study is relatively higher than that observed in previous study (9%).…”

Section: Roc Curve Analysiscontrasting

confidence: 99%

The Geriatric Nutrition Risk Index versus the Mini-Nutritional Assessment Short Form in predicting postoperative delirium and hospital length of stay among older non-cardiac surgical patients: a prospective cohort study

Zhao

Xie

et al. 2020

Preprint

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Backgrounds : Malnutrition has been shown to be associated with poor prognosis in older surgical patients. Several tools are available for detecting malnutrition. But little is known about their ability to assess risks of postoperative adverse outcomes. The study aimed to compare the ability of the Geriatric Nutritional Risk Index (GNRI) and the Mini-Nutritional Assessment Short Form (MNA-SF) in predicting postoperative delirium (POD) and length of stay (LOS) among older non-cardiac surgical patients. Methods : Prospective study of 288 older non-cardiac surgical patients from the West China Hospital of Sichuan University. Preoperative nutritional status was assessed using the GNRI and MNA-SF, and patients were followed for the occurrence of POD and LOS. Multivariable logistic regression and linear regression analyses were used to identify predictors of these outcomes. The relative performance of the GNRI and MNA-SF as predictors of these outcomes were determined by Receiver Operating Characteristic curves (ROC) analyses and the area under the curve (AUC) . Results : Multivariable analysis revealed that preoperative malnutrition by the MNA-SF was significantly associated with POD. Linear regression analysis showed that preoperative low/high nutritional risk of the GNRI and malnutrition by the MNA-SF were independent predictors of prolonged LOS. Moreover, the area under the curve (AUC) of MNA-SF scores for POD was better than GNRI scores (AUC=0.718, 95%CI: 0.64-0.80, P <0.001 vs AUC=0.606, 95%CI: 0.52-0.69, P= 0.019; Delong’s test, P=0.006), but the AUC of GNRI scores and MNA-SF scores have no significant difference when predicting prolonged LOS (AUC=0.611, 95%CI: 0.54-0.69, P= 0.006 vs AUC=0.533, 95%CI: 0.45-0.62, P= 0.421; Delong’s test, P=0.079). Conclusion : The MNA-SF was more effective than the GNRI at predicting the development of POD, but the two nutrition screening methods have similar performance in predicting prolonged LOS among older non-cardiac surgical patients.

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“…A study compared the efficiency of GNRI, PNI and CONUT on the prediction of delirium in coronary ICU patients and found no significant difference between PNI and CONUT. 25 However, PNI had the superiority in terms of convenience (CONUT is calculated by the serum albumin, serum total cholesterol and total lymphocyte counts).…”

Section: Discussionmentioning

confidence: 99%

Preoperative Prognostic Nutritional Index Value is Related to Postoperative Delirium in Elderly Patients After Noncardiac Surgery: A Retrospective Cohort Study

Liu¹,

Dai²,

Guan³

et al. 2021

RMHP

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Malnutrition has been considered as a risk factor for postoperative delirium (POD). The Prognostic Nutritional Index (PNI) is a validated tool for assessing nutritional status. This study aimed to investigate the association between preoperative PNI values and the occurrence of POD in elderly surgical patients. Methods: The retrospective cohort study included 361 elderly individuals who underwent noncardiac surgery between 2018 and 2019. Perioperative data were collected from the patients' medical records. PNI was used to evaluate preoperative nutritional status. The primary outcome was the occurrence of POD. Univariate and multivariate logistic regression analyses were used to identify key factors associated with POD and assess the relationship between PNI values and the occurrence of POD. Receiver operating characteristic (ROC) curve analysis was used to assess the predictive value of PNI for POD. Results: Seventy-two (19.9%) individuals developed postoperative delirium after surgery. Compared with patients of normal nutrition status (PNI ≥ 50), mild malnutrition (PNI 45-50) did not increase the risk of POD, while patients with moderate to severe malnutrition (PNI 40-45) (odds ratio [OR], 2.92; 95% confidence interval [CI], 1.31-6.50) and serious malnutrition (PNI < 40) (OR, 3.15; 95% CI, 1.12-8.83) were more likely to develop POD. The cut-off value of PNI was 46.05 by ROC curve analysis, the area under the curve (AUC) was 0.69 (95% CI 0.62-0.77). Conclusion:Preoperative PNI value is related to postoperative delirium in elderly patients after noncardiac surgery.

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Correlation of Nutritional Indices on Admission to the Coronary Intensive Care Unit with the Development of Delirium

Cited by 20 publications

References 34 publications

The geriatric nutrition risk index versus the mini-nutritional assessment short form in predicting postoperative delirium and hospital length of stay among older non-cardiac surgical patients: a prospective cohort study

The geriatric nutrition risk index versus the mini-nutritional assessment short form in predicting postoperative delirium and hospital length of stay among older non-cardiac surgical patients: a prospective cohort study

The Geriatric Nutrition Risk Index versus the Mini-Nutritional Assessment Short Form in predicting postoperative delirium and hospital length of stay among older non-cardiac surgical patients: a prospective cohort study

Preoperative Prognostic Nutritional Index Value is Related to Postoperative Delirium in Elderly Patients After Noncardiac Surgery: A Retrospective Cohort Study

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