Geriatric Nutritional Risk Index as a Screening Tool to Identify Patients with Malnutrition at a High Risk of In-Hospital Mortality among Elderly Patients with Femoral Fractures—A Retrospective Study in a Level I Trauma Center

Su, Wei-Ti; Wu, Shao-Chun; Huang, Chun-Ying; Chou, Sheng-En; Tsai, Ching-Hua; Li, Chi; Hsu, Shiun-Yuan; Hsieh, Ching-Hua

doi:10.3390/ijerph17238920

Cited by 13 publications

(22 citation statements)

References 50 publications

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“…[14][15][16][17] GNRI was also useful to identify the patients with malnutrition at a high risk of mortality among elderly patients with femoral fractures. 18 However, the prognostic value and the clinical impact of the GNRI scoring in elderly patients with fall injuries have not been established yet.…”

Section: Introductionmentioning

confidence: 99%

Association of a Low Geriatric Nutritional Risk Index with Higher Adverse Outcome in the Elderly Patients with Fall Injuries: Analysis of a Propensity Score-Matched Population

Huang¹,

Yin²,

Hsieh³

2021

RMHP

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Purpose We evaluate the association of Geriatric Nutritional Risk Index (GNRI) and the adverse outcome in elderly patients (≥65 years old) with fall injuries. Patients and Methods Total 1071 elderly patients with fall injuries were enrolled. Patients were divided into four groups: high risk, moderate risk, low risk and no risk (GNRI: <82, 82 to <92, 92 to ≤98 and >98) for patient demography, comorbidities, and adverse outcomes analysis. Results After 1:1 propensity score-matched analysis, 97 patients in high-risk group, 144 patients in moderate-risk group, and 114 patients in low-risk group were compared to no risk group. High-risk group patients had a 5.7-fold higher risk of mortality (p = 0.003) and prolong hospital stay (18.0 vs 12.3 days; p = 0.016) when compared to no-risk group patients. Significantly prolong hospital stay were also found in low-risk and moderate-risk group when compared to no risk group. Conclusion A lower GNRI is associated with prolonged hospital stay in the elderly patients with fall injuries. High nutritional risk (GNRI < 82) is associated with an increased in-hospital mortality rate.

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Section: Introductionmentioning

confidence: 99%

Association of a Low Geriatric Nutritional Risk Index with Higher Adverse Outcome in the Elderly Patients with Fall Injuries: Analysis of a Propensity Score-Matched Population

Huang¹,

Yin²,

Hsieh³

2021

RMHP

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“…We only included patients who had an independent ambulatory function before injury. This resulted in a relatively good nutritional status (mean GNRI score of >90 in both groups) [24], while our results indicate that subtle differences in the nutritional status were significantly related to ADL function after surgery. These results suggest that the patient status should be comprehensively assessed before injury, even in patients with good mobility before injury.…”

Section: Discussionmentioning

confidence: 88%

Preoperative and perioperative factors are related to the early postoperative Barthel Index score in patients with trochanteric fracture

Tomita

Yamamoto

Inoue

et al. 2022

International Journal of Rehabilitation Research

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Previous studies have shown that preoperative factors predict the postoperative Barthel Index score in patients with trochanteric fractures, while there is less evidence on the effects of perioperative factors on the prediction. This study aimed to assess the effects of preoperative and perioperative factors on the early postoperative Barthel Index score in patients with trochanteric fractures. Consecutive 288 patients aged ≥60 years with trochanteric fractures who could independently walk before injury were included. Patients were grouped according to the Barthel Index score measured after 2 weeks of surgery; the cut-off value was 20 points. Two logistic regression models were created to assess the effects of preoperative (model 1: dementia, walking ability before injury, and nutrition status) and perioperative (model 2: independent variables in model 1, reduction quality, and basic mobility function) factors on the Barthel Index score. Sensitivity and specificity were used to assess the predicative accuracy of the models. Poor preoperative (model 1: χ2 = 34.626, P < 0.01) and perioperative (model 2: χ2 = 43.956, P < 0.01) characteristics were significantly related to lower Barthel Index score. Sensitivity and specificity were similar between the models (model 1: 83.3% and 38.9% and model 2: 82.2% and 42.6%, respectively). Both preoperative and perioperative factors were significantly related to the early postoperative Barthel Index score after trochanteric fracture. However, only minimal increase in predictive accuracy was observed when perioperative predictors were analyzed along with preoperative factors. Both baseline characteristics and basic postoperative mobility should be considered when treating patients with trochanteric fractures.

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“…We collected the medical data of 35,154 patients ( Figure 1 ) between January 2009 and December 2018 from the trauma registry system of a level I trauma center in Southern Taiwan [ 17 – 20 ]. Only hospitalized adult patients (age ≥20 years) with TBI were included in this study.…”

Section: Methodsmentioning

confidence: 99%

The Association between Skull Bone Fractures and the Mortality Outcomes of Patients with Traumatic Brain Injury

Tsai

Rau

Huang

et al. 2022

Emergency Medicine International

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Introduction. Skull fractures are often found in patients with traumatic brain injury (TBI). Although skull fractures may indicate greater force impact and are associated with local or diffuse brain injuries, the prognostic value of skull fractures remains unclear. This retrospective study aimed to assess the association between skull fractures and mortality in patients with TBI. Methods. This study included 5,430 TBI patients registered in the trauma registry system from January 2009 to December 2018. Clinical and demographic data including age, sex, trauma mechanisms, comorbidities, Glasgow Coma Scale (GCS) score, abbreviated injury score (AIS)-head, injury severity score (ISS), and in-hospital mortality were acquired. Multiple logistic regression and propensity score matching were used to elucidate the effect of skull fractures on mortality outcomes of TBI patients. Results. Compared to TBI patients without skull fracture, patients with skull fractures were predominantly male, younger, had lower GCS upon arrival at the emergency room, and had higher AIS-head, ISS, and in-hospital mortality. The patients with skull fracture had 1.7-fold adjusted odds of mortality (95% confidence interval (CI): 1.27–2.25; p < 0.001 ) than those without skull fracture, controlling for age, sex, comorbidities, and AIS-head. Additionally, the propensity score-matched analysis of 1,023 selected paired patients revealed that skull fracture was significantly associated with increased 1.4-fold odds of risk for mortality (95% CI: 1.02–1.88; p = 0.036 ). Conclusions. Using a propensity score-matched cohort to attenuate the confounding effect of age, comorbidities, and injury severity, skull fracture was identified as a significant independent risk factor for mortality in patients with TBI.

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Geriatric Nutritional Risk Index as a Screening Tool to Identify Patients with Malnutrition at a High Risk of In-Hospital Mortality among Elderly Patients with Femoral Fractures—A Retrospective Study in a Level I Trauma Center

Cited by 13 publications

References 50 publications

Association of a Low Geriatric Nutritional Risk Index with Higher Adverse Outcome in the Elderly Patients with Fall Injuries: Analysis of a Propensity Score-Matched Population

Association of a Low Geriatric Nutritional Risk Index with Higher Adverse Outcome in the Elderly Patients with Fall Injuries: Analysis of a Propensity Score-Matched Population

Preoperative and perioperative factors are related to the early postoperative Barthel Index score in patients with trochanteric fracture

The Association between Skull Bone Fractures and the Mortality Outcomes of Patients with Traumatic Brain Injury

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