Severe Nutritional Risk Predicts Decreased Long-Term Survival in Geriatric Patients Undergoing Pancreaticoduodenectomy for Benign Disease

AbstractMalnutrition and acute kidney injury (AKI) are common complications in hospitalised patients, and both increase mortality; however, the relationship between them is unknown. This is a retrospective propensity score matching study enrolling 46 549 inpatients, aimed to investigate the association between Nutritional Risk Screening 2002 (NRS-2002) and AKI and to assess the ability of NRS-2002 and AKI in predicting prognosis. In total, 37 190 (80 %) and 9359 (20 %) patients had NRS-2002 scores <3 and ≥3, respectively. Patients with NRS-2002 scores ≥3 had longer lengths of stay (12·6 (sd 7·8) v. 10·4 (sd 6·2) d, P < 0·05), higher mortality rates (9·6 v. 2·5 %, P < 0·05) and higher incidence of AKI (28 v. 16 %, P < 0·05) than patients with normal nutritional status. The NRS-2002 showed a strong association with AKI, that is, the risk of AKI changed in parallel with the score of the NRS-2002. In short- and long-term survival, patients with a lower NRS-2002 score or who did not have AKI achieved a significantly lower risk of mortality than those with a high NRS-2002 score or AKI. Univariate Cox regression analyses indicated that both the NRS-2002 and AKI were strongly related to long-term survival (AUC 0·79 and 0·71) and that the combination of the two showed better accuracy (AUC 0·80) than the individual variables. In conclusion, malnutrition can increase the risk of AKI and both AKI and malnutrition can worsen the prognosis that the undernourished patients who develop AKI yield far worse prognosis than patients with normal nutritional status.

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Surgery for Non-Small Cell Carcinoma in Geriatric Patients: 15-Year Experience

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849230501300408 ◽

2005 ◽

Vol 13 (4) ◽

pp. 330-336 ◽

Cited By ~ 14

Author(s):

Horia Sirbu ◽

Waldemar Schreiner ◽

Harald Dalichau ◽

Thomas Busch

Keyword(s):

Lung Carcinoma ◽

Geriatric Patients ◽

Small Cell Lung Carcinoma ◽

Small Cell ◽

Disease Stage ◽

Small Cell Lung ◽

Term Survival ◽

Cell Lung Carcinoma ◽

Long Term Survival

The purpose of this study was to determine the clinical patterns, short- and long-term survival in elderly patients after surgery for non-small cell lung carcinoma. The 273 patients aged over 70 years who underwent curative resection from 1986 to 2001 were retrospectively assessed. Mean age was 73.2 ± 3.1 years, (11% were > 80 years). The mean follow-up was 31 months. Standard procedures were used: 151 lobectomies, 49 bilateral lobectomies, 42 pneumonectomies, 9 sleeve resections, and 22 wedge resections. The 30-day mortality was 5.4%. Multivariate analysis showed that extended procedures, male sex, and age were predictors of mortality. Overall survival rates at 5, 10, and 15 years were 35.6%, 10.5%, and 2.5%, respectively. Advanced disease stage, low forced expiratory volume in 1 second, and previous cardiac disease were independent predictors that adversely influenced survival. Geriatric patients with non-small cell lung carcinoma can undergo resection safely with acceptable long-term survival. Lobectomy is the procedure of choice, extended resections should only be carried out in highly selected patients. Careful attention to preoperative clinical staging is important as the elderly beyond the early stage of disease fare poorly. Surgery is justified for the treatment of stage I–II lung cancer.

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P1956Geriatric nutritional risk index as predictor for long-term survival and cardiovascular or limb events in peripheral arterial disease patients

European Heart Journal ◽

10.1093/eurheartj/ehz748.0703 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

Y Matsuo ◽

H Kumakura ◽

T Shirakura ◽

K Ichikawa ◽

R Funada ◽

...

Keyword(s):

Risk Index ◽

Arterial Disease ◽

Cardiovascular Death ◽

Nutritional Risk ◽

Term Survival ◽

Long Term Survival ◽

Nutritional Risk Index ◽

Artery Disease

Abstract Background The geriatric nutritional risk index (GNRI) is a simple tool to assess the nutritional risk and associated with mortality. However, there are no reports focusing GNRI in peripheral artery disease (PAD) patients. Purpose The purpose of this study was to examine the effects of GNRI for long-term survival, cardiovascular and limb events in PAD patients. Methods A prospective cohort study was performed in 1219 PAD patients. Baseline GNRI was calculated from serum albumin level and body-mass-index. The patients were divided into four groups by GNRI level (G1: >98; G2: 92–98; G3: 82–91; G4: <82). The endpoints were overall survival (OS) and freedom from major adverse cardiovascular and limb events (MACE and MACLE). Results The median follow-up was 73 months. There were 626 deaths (51.4%) during follow-up. The rate of cardiovascular death among dead was 51.3%. The OS rates markedly depended on GNRI level (p<0.01). The 5-year OS rates were G1: 80.8%, G2: 62.0%, G3: 40.0%, G4: 23.3%, respectively. In multivariate analyses, GNRI, age, low ankle brachial pressure index (ABI), low estimated glomerular filtration rate (eGFR), and high C-reactive protein (CRP) levels were independent factors associated with OS (<0.05). GNRI, age, low ABI, diabetes mellitus, coronary artery disease, lower eGFR and higher CRP levels were associated with MACE and MACLE (p<0.05, respectively). Besides, statins improved OS, MACE, and MACLE (<0.01, respectively). Conclusions GNRI was an independent predictor for OS, MACE, and MACLE in PAD patients. Furthermore,statins improved OS, MACE and MACLE in patients with PAD.

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