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

Abstract

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.

The Relationship of Malnutrition With Cognitive Function in the Older Chinese Population: Evidence From the Chinese Longitudinal Healthy Longevity Survey Study

“…The area under the curve (AUC) of the GNRI predicting a composite of events such as all-cause death was 0.873 in the Chinese population ( Zhao Q. et al, 2020 ). The validity and reliability of the GNRI among Chinese or Asian older adults have been reported in previous studies ( Abd Aziz et al, 2019 ; Nishi et al, 2019 ; Zhao Y. et al, 2020 ).…”

A Comparison of the Malnutrition Universal Screening Tool (MUST) and the Mini Nutritional Assessment-Short Form (MNA-SF) Tool for Older Patients Undergoing General Surgery

“…Similar results have been reported recently by Zhao et al In this study, elderly non-cardiac surgical patients were assessed with the MNA-SF and the geriatric nutritional risk index (GNRI) with regard to postoperative delirium and length of stay. Both tools were independent predictors of prolonged LOS and performed equally in predicting longer hospitalisation [25]. These results highlight the need for preoperative malnutrition assessment in elderly patients, the optimisation of which before surgery can contribute to a shorter postoperative stay.…”

A novel nutritional index “simplified CONUT” and the disease risk index independently stratify prognosis of elderly patients with acute myeloid leukemia

“…In the current study, we find that the NCCN 2017 is also feasible for elderly patients with 65 years old or older. The nutritional status assessments using GNRI; BMI and serum level of Alb, PNI; serum level of Alb and TLC, and CONUT score; serum level of Alb, TLC and T-chol, are developed to predict tolerability to cancer treatment in the elderly patients with solid tumors 3,4,[15][16][17] . Recently, the CONUT score has been shown to predict prognosis in patients with some hematological malignancies [5][6][7][8] .…”