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The Geriatric Nutritional Risk Index is a powerful predictor of adverse outcome in the elderly emergency surgery patient

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Harvard

Jia, Z, El Moheb, M, Nordestgaard, A, Lee, JM, Meier, K, Kongkaewpaisan, N, Han, K, El Hechi, MW, Mendoza, A, King, D, Fagenholz, P, Saillant, N, Rosenthal, M, Velmahos, G & Kaafarani, HMA 2020, 'The Geriatric Nutritional Risk Index is a powerful predictor of adverse outcome in the elderly emergency surgery patient', The journal of trauma and acute care surgery, bind 89, nr. 2, s. 397-404. https://doi.org/10.1097/TA.0000000000002741

APA

Jia, Z., El Moheb, M., Nordestgaard, A., Lee, J. M., Meier, K., Kongkaewpaisan, N., Han, K., El Hechi, M. W., Mendoza, A., King, D., Fagenholz, P., Saillant, N., Rosenthal, M., Velmahos, G., & Kaafarani, H. M. A. (2020). The Geriatric Nutritional Risk Index is a powerful predictor of adverse outcome in the elderly emergency surgery patient. The journal of trauma and acute care surgery, 89(2), 397-404. https://doi.org/10.1097/TA.0000000000002741

CBE

Jia Z, El Moheb M, Nordestgaard A, Lee JM, Meier K, Kongkaewpaisan N, Han K, El Hechi MW, Mendoza A, King D, Fagenholz P, Saillant N, Rosenthal M, Velmahos G, Kaafarani HMA. 2020. The Geriatric Nutritional Risk Index is a powerful predictor of adverse outcome in the elderly emergency surgery patient. The journal of trauma and acute care surgery. 89(2):397-404. https://doi.org/10.1097/TA.0000000000002741

MLA

Vancouver

Author

Jia, Zhenyi ; El Moheb, Mohamad ; Nordestgaard, Ask ; Lee, Jae Moo ; Meier, Karien ; Kongkaewpaisan, Napaporn ; Han, Kelsey ; El Hechi, Majed W ; Mendoza, April ; King, David ; Fagenholz, Peter ; Saillant, Noelle ; Rosenthal, Martin ; Velmahos, George ; Kaafarani, Haytham M A. / The Geriatric Nutritional Risk Index is a powerful predictor of adverse outcome in the elderly emergency surgery patient. I: The journal of trauma and acute care surgery. 2020 ; Bind 89, Nr. 2. s. 397-404.

Bibtex

@article{270b7e51115e4466ba8f09654238c43f,
title = "The Geriatric Nutritional Risk Index is a powerful predictor of adverse outcome in the elderly emergency surgery patient",
abstract = "BACKGROUND: The degree to which malnutrition impacts perioperative outcomes in the elderly emergency surgery (ES) patient remains unknown. We aimed to study the relationship between malnutrition, as measured by the Geriatric Nutritional Risk Index (GNRI), and postoperative outcomes in elderly patients undergoing ES. METHODS: Using the 2007 to 2016 American College of Surgeons National Surgical Quality Improvement Program database, all patients 65 years or older undergoing ES were included in our study. The GNRI, defined as (1.489 × albumin [g/L]) + (41.7 × [weight/ideal weight]) was calculated for each patient in the database. Patients with missing height, weight, or preoperative albumin data were excluded. Patients were divided into four malnutrition groups: very severe (GNRI < 73), severe (GNRI, 73-82), moderate (GNRI, 82-92), and mild (GNRI, 92-98). Geriatric Nutritional Risk Index greater than 98 constituted the normal nutrition group. Risk-adjusted multivariable logistic regressions were performed to study the relationship between malnutrition-measured using either GNRI, albumin level, or body mass index less than 18.5 kg/m-and the following postoperative outcomes: 30-day mortality, 30-day morbidity (including infectious and noninfectious complications), and hospital length of stay. The relationship between GNRI score and 30-day mortality for six common ES procedures was then assessed. RESULTS: A total of 82,725 patients were included in the final analyses. Of these, 55,214 were malnourished with GNRI less than 98 (66.74%). Risk-adjusted multivariable analyses showed that, as malnutrition worsened from mild to very severe, the risk of mortality, morbidity, and the hospital length of stay progressively increased (all p < 0.05). Patients with very severe malnutrition had at least a twofold increased likelihood of mortality (odds ratio [OR], 2.79; 95% confidence interval [CI], 2.57-3.03), deep vein thrombosis (OR, 2.07; 95% CI, 1.77-2.42), and respiratory failure (OR, 1.95; 95% CI, 1.81-2.11). Geriatric Nutritional Risk Index predicted mortality better than albumin or body mass index alone for ES. CONCLUSION: Malnutrition, measured using GNRI, is a strong independent predictor of adverse outcomes in the elderly ES patient and could be used to assess the nutrition status and counsel patients (and families) preoperatively. LEVEL OF EVIDENCE: Prognostic study, Level IV.",
author = "Zhenyi Jia and {El Moheb}, Mohamad and Ask Nordestgaard and Lee, {Jae Moo} and Karien Meier and Napaporn Kongkaewpaisan and Kelsey Han and {El Hechi}, {Majed W} and April Mendoza and David King and Peter Fagenholz and Noelle Saillant and Martin Rosenthal and George Velmahos and Kaafarani, {Haytham M A}",
year = "2020",
month = aug,
doi = "10.1097/TA.0000000000002741",
language = "English",
volume = "89",
pages = "397--404",
journal = "Journal of Trauma and Acute Care Surgery",
issn = "2163-0755",
publisher = "Lippincott Williams & Wilkins",
number = "2",

}

RIS

TY - JOUR

T1 - The Geriatric Nutritional Risk Index is a powerful predictor of adverse outcome in the elderly emergency surgery patient

AU - Jia, Zhenyi

AU - El Moheb, Mohamad

AU - Nordestgaard, Ask

AU - Lee, Jae Moo

AU - Meier, Karien

AU - Kongkaewpaisan, Napaporn

AU - Han, Kelsey

AU - El Hechi, Majed W

AU - Mendoza, April

AU - King, David

AU - Fagenholz, Peter

AU - Saillant, Noelle

AU - Rosenthal, Martin

AU - Velmahos, George

AU - Kaafarani, Haytham M A

PY - 2020/8

Y1 - 2020/8

N2 - BACKGROUND: The degree to which malnutrition impacts perioperative outcomes in the elderly emergency surgery (ES) patient remains unknown. We aimed to study the relationship between malnutrition, as measured by the Geriatric Nutritional Risk Index (GNRI), and postoperative outcomes in elderly patients undergoing ES. METHODS: Using the 2007 to 2016 American College of Surgeons National Surgical Quality Improvement Program database, all patients 65 years or older undergoing ES were included in our study. The GNRI, defined as (1.489 × albumin [g/L]) + (41.7 × [weight/ideal weight]) was calculated for each patient in the database. Patients with missing height, weight, or preoperative albumin data were excluded. Patients were divided into four malnutrition groups: very severe (GNRI < 73), severe (GNRI, 73-82), moderate (GNRI, 82-92), and mild (GNRI, 92-98). Geriatric Nutritional Risk Index greater than 98 constituted the normal nutrition group. Risk-adjusted multivariable logistic regressions were performed to study the relationship between malnutrition-measured using either GNRI, albumin level, or body mass index less than 18.5 kg/m-and the following postoperative outcomes: 30-day mortality, 30-day morbidity (including infectious and noninfectious complications), and hospital length of stay. The relationship between GNRI score and 30-day mortality for six common ES procedures was then assessed. RESULTS: A total of 82,725 patients were included in the final analyses. Of these, 55,214 were malnourished with GNRI less than 98 (66.74%). Risk-adjusted multivariable analyses showed that, as malnutrition worsened from mild to very severe, the risk of mortality, morbidity, and the hospital length of stay progressively increased (all p < 0.05). Patients with very severe malnutrition had at least a twofold increased likelihood of mortality (odds ratio [OR], 2.79; 95% confidence interval [CI], 2.57-3.03), deep vein thrombosis (OR, 2.07; 95% CI, 1.77-2.42), and respiratory failure (OR, 1.95; 95% CI, 1.81-2.11). Geriatric Nutritional Risk Index predicted mortality better than albumin or body mass index alone for ES. CONCLUSION: Malnutrition, measured using GNRI, is a strong independent predictor of adverse outcomes in the elderly ES patient and could be used to assess the nutrition status and counsel patients (and families) preoperatively. LEVEL OF EVIDENCE: Prognostic study, Level IV.

AB - BACKGROUND: The degree to which malnutrition impacts perioperative outcomes in the elderly emergency surgery (ES) patient remains unknown. We aimed to study the relationship between malnutrition, as measured by the Geriatric Nutritional Risk Index (GNRI), and postoperative outcomes in elderly patients undergoing ES. METHODS: Using the 2007 to 2016 American College of Surgeons National Surgical Quality Improvement Program database, all patients 65 years or older undergoing ES were included in our study. The GNRI, defined as (1.489 × albumin [g/L]) + (41.7 × [weight/ideal weight]) was calculated for each patient in the database. Patients with missing height, weight, or preoperative albumin data were excluded. Patients were divided into four malnutrition groups: very severe (GNRI < 73), severe (GNRI, 73-82), moderate (GNRI, 82-92), and mild (GNRI, 92-98). Geriatric Nutritional Risk Index greater than 98 constituted the normal nutrition group. Risk-adjusted multivariable logistic regressions were performed to study the relationship between malnutrition-measured using either GNRI, albumin level, or body mass index less than 18.5 kg/m-and the following postoperative outcomes: 30-day mortality, 30-day morbidity (including infectious and noninfectious complications), and hospital length of stay. The relationship between GNRI score and 30-day mortality for six common ES procedures was then assessed. RESULTS: A total of 82,725 patients were included in the final analyses. Of these, 55,214 were malnourished with GNRI less than 98 (66.74%). Risk-adjusted multivariable analyses showed that, as malnutrition worsened from mild to very severe, the risk of mortality, morbidity, and the hospital length of stay progressively increased (all p < 0.05). Patients with very severe malnutrition had at least a twofold increased likelihood of mortality (odds ratio [OR], 2.79; 95% confidence interval [CI], 2.57-3.03), deep vein thrombosis (OR, 2.07; 95% CI, 1.77-2.42), and respiratory failure (OR, 1.95; 95% CI, 1.81-2.11). Geriatric Nutritional Risk Index predicted mortality better than albumin or body mass index alone for ES. CONCLUSION: Malnutrition, measured using GNRI, is a strong independent predictor of adverse outcomes in the elderly ES patient and could be used to assess the nutrition status and counsel patients (and families) preoperatively. LEVEL OF EVIDENCE: Prognostic study, Level IV.

UR - http://www.scopus.com/inward/record.url?scp=85089045898&partnerID=8YFLogxK

U2 - 10.1097/TA.0000000000002741

DO - 10.1097/TA.0000000000002741

M3 - Journal article

C2 - 32744834

VL - 89

SP - 397

EP - 404

JO - Journal of Trauma and Acute Care Surgery

JF - Journal of Trauma and Acute Care Surgery

SN - 2163-0755

IS - 2

ER -

ID: 60799193