scholarly journals Geriatric Nutritional Risk Index and Controlling Nutritional Status Score can predict postoperative 180-day mortality in hip fracture surgeries

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Atsushi Kotera
Keyword(s):  
Hip Fracture ◽  
Nutritional Status ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Risk Index ◽  
Albumin Level ◽  
Nutritional Risk ◽  
Geriatric Nutritional Risk Index ◽  
Status Score ◽  
Nutritional Risk Index

Abstract Background The Geriatric Nutritional Risk Index (GNRI) based on serum albumin level and body weight and the Controlling Nutritional Status Score (CONUT) based on serum albumin level, total cholesterol level, and total lymphocyte count were created to evaluate objectively a patient’s nutritional status in 2005. Here we validated the usefulness of the GNRI and the CONUT as a prognostic factor of the 180-day mortality in patients who underwent hip fracture surgeries. We retrospectively collected data from patients with hip surgeries performed from January 2012 to December 2018. The variables required for the GNRI and the CONUT and the factors presumably associated with postoperative mortality including the patients’ characteristics were collected from the medical charts. Intergroup differences were assessed with the χ2 test with Yates’ correlation for continuity in category variables. The Mann-Whitney U test was used to test for differences in continuous variables. We validated the power of the GNRI and the CONUT values to distinguish patients who died ≤ 180 days post-surgery from those who did not, by calculating the area under the receiver operating characteristic curve (AUC). The correlation between these two models was analyzed by Spearman’s rank correlation (ρ). Results We retrospectively examined the cases of 607 patients aged 87 ± 6 (range 70–102) years old. The 180-day mortality rate was 5.4% (n = 33 non-survivors). The GNRI value in the non-survivors was 83 ± 9 (range 66–111), which was significantly lower than that in the survivors at 92 ± 9 (range 64–120). The CONUT value in the non-survivors was 6 ± 3 (range 1–11), which was significantly higher than that in the survivors at 4 ± 2 (range 0–11). The AUC value to predict the 180-day mortality was 0.74 for the GNRI and 0.72 for the CONUT. The ρ value between these two models was 0.61 in the total of 607 patients and was 0.78 in the 33 non-survivors. Conclusions Our results suggest that the GNRI and the CONUT are a simple and useful tool to predict the 180-day mortality in patients who have undergone a hip surgery.

scholarly journals Geriatric nutritional risk index predicts prognosis in hepatocellular carcinoma after hepatectomy: a propensity score matching analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hiroki Kanno ◽  
Yuichi Goto ◽  
Shin Sasaki ◽  
Shogo Fukutomi ◽  
Toru Hisaka ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Propensity Score ◽  
Serum Albumin ◽  
Propensity Score Matching ◽  
Serum Albumin Level ◽  
Risk Index ◽  
Albumin Level ◽  
Nutritional Risk ◽  
Geriatric Nutritional Risk Index ◽  
Nutritional Risk Index

AbstractThe geriatric nutritional risk index (GNRI) is widely used for nutritional assessment in older inpatients and is associated with postoperative complications and cancer prognosis. We investigated the use of GNRI to predict long-term outcomes in hepatocellular carcinoma of all etiologies after hepatectomy. Overall, 346 patients were examined after propensity score matching. We dichotomized the GNRI score into high GNRI (> 98: N = 173) and low GNRI (≤ 98: N = 173) and evaluated recurrence-free survival (RFS) and overall survival (OS) between both groups. Clinicopathological characteristics between the low- and high-GNRI groups were similar after propensity score matching except for the components of the GNRI score (body mass index and serum albumin level), Child–Pugh score (comprising serum albumin level), and preoperative alpha-fetoprotein level (p < 0.0001, p < 0.0001, p = 0.0030, and p = 0.0007, respectively). High GNRI was associated with significantly better RFS and OS (p = 0.0003 and p = 0.0211, respectively; log-rank test). Multivariate analysis revealed that GNRI is an independent prognostic factor of RFS and OS (low vs. high; hazard ratio [HR], 1.8284; 95% confidence interval [CI] 1.3598–2.4586; p < 0.0001, and HR, 1.5452; 95% CI 1.0345–2.3079; p = 0.0335, respectively). GNRI is an objective, inexpensive, and easily calculated assessment tool for nutritional status and can predict prognosis of hepatocellular carcinoma after hepatectomy.

scholarly journals Geriatric Nutritional Risk Index Predicts Prognosis in Hepatocellular Carcinoma After Hepatectomy: A Propensity Score Matching Analysis

2021 ◽  
Author(s):  
Hiroki Kanno ◽  
Yuichi Goto ◽  
Shin Sasaki ◽  
Shogo Fukutomi ◽  
Toru Hisaka ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Propensity Score ◽  
Serum Albumin ◽  
Propensity Score Matching ◽  
Serum Albumin Level ◽  
Risk Index ◽  
Albumin Level ◽  
Nutritional Risk ◽  
Geriatric Nutritional Risk Index ◽  
Nutritional Risk Index

Abstract The geriatric nutritional risk index (GNRI) is widely used for nutritional assessment in older inpatients and was recently reported to be associated with postoperative complications and cancer prognosis. We investigated the use of the GNRI to predict long-term outcomes in hepatocellular carcinoma of all etiologies after hepatectomy. 358 patients were reviewed after propensity score matching. We dichotomized the GNRI score into high GNRI (> 98: N = 179) and low GNRI (≤ 98: N = 179) and evaluated recurrence-free survival (RFS) and overall survival (OS) between the two groups. Clinicopathological characteristics between the low- and high-GNRI groups were similar after propensity score matching except for the components of the GNRI score (body mass index and serum albumin level), Child–Pugh score (consisting serum albumin level), and preoperative alpha-fetoprotein level (p < .0001, p < .0001, p = 0.0060, and p = 0.0049, respectively). A high GNRI was associated with significantly better RFS and OS (p = 0.0001 and p = 0.0055, respectively; log-rank test). Multivariate analysis revealed that GNRI is an independent prognostic factor of RFS and OS (low vs. high; HR, 1.8670; 95%CI, 1.4011–2.4880; p < .0001, HR, 1.7270; 95% CI, 1.1640–2.5623; p = 0.0066, respectively). The GNRI is an objective, inexpensive, and easily calculated assessment tool for nutritional status and can predict prognosis in hepatocellular carcinoma after hepatectomy.

Impact of Nutritional Status on Peritonitis in CAPD Patients

2007 ◽  
Vol 27 (1) ◽  
pp. 42-47 ◽  
Author(s):  
Narayan Prasad ◽  
Amit Gupta ◽  
Raj K. Sharma ◽  
Archna Sinha ◽  
Ramesh Kumar
Keyword(s):  
Nutritional Status ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Risk Index ◽  
Univariate Analysis ◽  
Albumin Level ◽  
Calorie Intake ◽  
Cox Regression Analysis ◽  
Nutritional Risk Index ◽  
The Impact

Objective To determine the impact of nutritional status on peritonitis in patients on continuous ambulatory peritoneal dialysis (CAPD) in a developing country. Methods 56 patients with end-stage renal disease on CAPD were randomly selected for this study. These patients were assessed for nutritional status and peritonitis episodes. Nutritional parameters were assessed by anthropometry, diet, body mass index (BMI), Nutritional Risk Index (NRI), serum albumin level, and Subjective Global Assessment (SGA). Based on SGA, patients were categorized into either group 1 (malnutrition, n = 31) or group 2 (normal nutritional status, n = 25). Peritonitis was considered the primary outcome and was compared between the two groups. Results Demographic profiles, Kt/V, creatinine clearance, and mean follow-up of the two groups were similar. Number of peritonitis episodes was significantly higher in patients with malnutrition (25/31) compared to patients with normal nutritional status (4/25) ( p = 0.001). Mean peritonitis rate per patient per year was also significantly higher in patients with malnutrition (0.99 ± 1.07) compared to patients with normal nutritional status (0.18 ± 0.42) ( p = 0.007). On univariate analysis, malnutrition based on SGA ( p = 0.009), NRI ( p = 0.02), serum albumin level ( p = 0.005), and calorie intake ( p = 0.006) was a significant predictor of peritonitis. On multivariate Cox regression analysis, only SGA ( p = 0.001, odds ratio 0.08, 95% confidence interval 0.02 – 0.36) was found to be a significant predictor of peritonitis. On general linear model, the observed power of prediction of peritonitis was 0.96 based on SGA. On Kaplan–Meier survival analysis, peritonitis-free survival in patients with normal nutrition (42 months) was significantly higher compared to patients with malnutrition (21 months) based on SGA (log rank p = 0.003). Conclusion We conclude that peritonitis rate is high in patients with malnutrition and that malnutrition indices, especially SGA, can predict the peritonitis rate in CAPD patients.

scholarly journals Serum Albumin Level, but Not Nutritional Risk Index Predicts Outcomes in Acute Leukemia Patients after Allo-HSCT

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 1987-1987
Author(s):  
Mikhail Yu. Drokov ◽  
Natalia N. Popova ◽  
Vera A. Vasilyeva ◽  
Ekaterina D. Mikhaltsova ◽  
Olga M. Koroleva ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Serum Albumin Level ◽  
Risk Index ◽  
Conditioning Regimen ◽  
Ideal Body Weight ◽  
Albumin Level ◽  
Nutritional Risk ◽  
Long Term Results ◽  
Nutritional Risk Index

Background: Nutritional problem is a key aspect of all severe diseases that always "keep in the shadows". There are different factors, such as intensive chemotherapy, constant nausea, severe infections, time for donor search that affect nutritional status in leukemia patients who underwent allogeneic stem cell transplantation (allo-HSCT). This study aimed to evaluate the impact of different "nutritional status assessment tools" on outcomes of allogeneic hematopoietic cell transplantation. Materials and methods: 307 leukemia patients who underwent allo-HSCT in National Research Center for Hematology from 2011-2019 were included on this study. Detailed patients' characteristics are given in Table 1. All data were collected directly before allo-HSCT conditioning regimen. Nutritional Risk Index (NRI) was calculated by NRI = (1.519 × serum albumin, g/dL) + (41.7 × present weight (kg)/ideal body weight(kg)). Ideal body weight (IBW) was calculated by Lorentz IBW formula: for men IBW = (height, cm− 100) − ((height − 150)/4); for women: IBW = (height, cm − 100) − ((height, cm − 150)/2). All patients were stratified according to NRI: NRI < 83.5 - Major; 83.5 ≤NRI < 97.5 - Moderate; 97.5 ≤NRI < 100 - Mild; NRI≥100 - No risk group. Moreover all patients were stratified according to serum albumin level (more and less than 4.3 mg/dl ). Groups stratified by NRI and serum albumin was balanced for factors that can affect long-term results: disease type and status, graft source, conditioning regimen, donor's type, graft failure, acute and chronic GVHD. Data analysis was performed with R version 3.5.2 (Core Team, 2018). Chi-square and Fisher's exact test were used for contingency tables. Kaplan-Meier analysis was provided to assess the probability of overall survival. Log-rank test was used to compare two groups. Cox regression model was used to identify independent prognostic factors and its hazard ratio (HR) with a 95% confidence interval (95% CI). Age, sex, disease status before allo-HSCT (CR vs not in CR), serum albumin level (83.5 <4.3 vs ≥4.3 mg/dl), NRI, donor type (MUD, MMUD, Haplo vs MRD), conditioning regimen (MAC vs RIC) was included as independent covariates.P-value of 0.05 was considered as significant. Results: As we can see on Figure 1A NRI-based stratification can't help us to predict long-term results in contrast with serum albumin level (Figure 1B). At the same time level of albumin >4.3 was associated with better results compared to serum albumin level <4.3 mg/dl (p=0.02). According to Cox model there are several independent prognostic factors : disease status before allo-HSCT (CR vs not in CR) - HR=3.79 (95% CI 2.45-5.8; p=0.0001); donor type (MMUD vs MRD and Haplo vs MRD) - HR=1.67 (95% CI 1.09-2.57; p=0.017) and HR=2.7 (95% CI 1.2-5.8; p=0.011) respectively. Serum albumin level was also identified as an independent prognostic with HR=1.76 (95% CI 1.14-2.72; p=0.011). Other factors including NRI were not significant. Conclusion: These data showed that serum albumin level, but not NRI index, in leukemia patients before allo-HSCT can predict long term outcomes. Identification of these high risk patients could be a start point for future interventions and could change care protocols. Disclosures No relevant conflicts of interest to declare.

Abstract 12880: Malnutrition Assessed by Geriatric Nutritional Risk Index Provides the Long-term Prognostic Information in Patients Admitted for Acute Decompensated Heart Failure, Regardless of Reduced or Preserved Left Ventricular Ejection Fraction; A Comparison With Prognostic Nutritional Index and CONUT Score

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Takahisa Yamada ◽  
Takashi Morita ◽  
Yoshio Furukawa ◽  
Shunsuke Tamaki ◽  
Yusuke Iwasaki ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Serum Albumin ◽  
Risk Index ◽  
Left Ventricular ◽  
Nutritional Risk ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Nutritional Index ◽  
Nutritional Risk Index ◽  
Conut Score

Backgrounds: Malnutrition is associated with increased mortality risk in patients (pts) with acute decompensated heart failure(ADHF). Nutritional status is assessed by several indices, such as Geriatric Nutritional Risk Index (GNRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) score. However, there is no information available on the comparison of prognostic significance of these indices in ADHF pts, relating to reduced or preserved left ventricular ejection fraction (HFrEF or HFpEF). Methods and Results: We studied 303 consecutive pts admitted for ADHF and discharged alive (HFrEF(LVEF<50%);n=163, HFpEF(LVEF≥50%);n=140). Nutritional status was evaluated at the discharge by GNRI calculated as follows: 14.89 • serum albumin (g/dl) + 41.7 • BMI/22, PNI calculated as follows: 10 • serum albumin (g/dl) + 0.005 • total lymphocyte count (/ml) and CONUT score calculated by serum albumin, total cholesterol levels and lymphocyte count. During a follow-up period of 5.0±4.3 yrs, 75 pts had cardiovascular death (CVD). At multivariate Cox analysis, GNRI (p<0.0001) was significantly associated with CVD, independently of systolic blood pressure, serum sodium level and eGFR, although PNI and CONUT score showed a significant association with CVD at univariate analysis. ROC analysis revealed that GNRI of 88 was a fair discriminator for CVD (AUC 0.70(95%CI 0.63-0.77), p<0.0001). In group with HFrEF, CVD was significantly more frequently observed in pts with than without low GNRI <88 (48% vs 25%, p<0.0001, adjusted HR 3.5[1.8-6.6]). Furthermore, in group with HFpEF, pts with low GNRI had the significantly increased risk, compared to those with high GNRI>88 (36% vs 10%, p<0.0001, adjusted HR 3.8[1.4-10.2]). Conclusion: Malnutrition assessed by Geriatric Nutritional Index provides more valuable long-term prognostic information than PNI and CONUT score in pts admitted for ADHF, regardless of HFrEF or HFpEF.

Abstract 12986: Geriatric Nutritional Risk Index Provides the Additional Long-term Prognostic Information to Gwtg Heart Failure Risk Score in Acute Decompensated Heart Failure Patients With and Without Reduced LVEF

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Takahisa Yamada ◽  
Tetsuya Watanabe ◽  
Takashi Morita ◽  
Yoshio Furukawa ◽  
Shunsuke Tamaki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Nutritional Status ◽  
Risk Score ◽  
Risk Index ◽  
Nutritional Risk ◽  
Geriatric Nutritional Risk Index ◽  
Prognostic Information ◽  
Poor Outcome ◽  
Nutritional Risk Index

Backgrounds: The Get with The Guidelines (GWTG) heart failure (HF) risk score was developed in the GWTG inpatient HF registry to predict in-hospital mortality and has been recently reported to be associated with post-discharge long-term outcomes. Malnutrition is associated with poor outcome in ADHF patients. However, there is no information available on the long-term prognostic significance of the combination of GWTG-HF risk score and malnutrition in patients admitted for ADHF, relating to reduced left ventricular ejection fraction (LVEF). Methods: We studied 303 ADHF patients discharged with survival (HFrEF(LVEF<40%); n=180, HFpEF(LVEF≥40%;n=123). At the admission, we evaluated GWTG-HF score and nutritional status. Variables required for the GWTG-HF risk score were race, age, systolic blood pressure, heart rate, serum levels of blood urea nitrogen and sodium, and the presence of chronic obstructive pulmonary disease. Nutritional status was evaluated by Geriatric Nutritional Risk Index (GNRI) calculated as follows: 14.89 · serum albumin (g/dl) + 41.7 · BMI/22, and malnutrition was defined as GNRI<92. The study endpoint was cardiovascular-renal poor outcome (CVR), defined as cardiovascular death and the development of end-stage renal disease requiring renal replacement therapy. Results: During a follow-up period of 4.2±3.3 yrs, 86 patients had CVR. At multivariate Cox analysis, GWTG-HF risk score and GNRI were significantly and independently associated with CVR, in both HFrEF and HFpEF groups. The patients with both greater GWTG-HF score (>median value=35) and malnutrition had a significantly increased risk of CVR than those with either and none of them ([HFrEF] 60% vs 32% vs 16%, p<0.0001, [HFpEF] 45% vs 18% vs 12%, p<0.0001, respectively) Conclusion: Malnutrition assessed by GNRI would provide the additional long-term prognostic information to GWTG-HF risk score in patients admitted for ADHF, irrespective of the presence of reduced LV function.

scholarly journals Vitamin D deficiency is associated with reduced mobility after hip fracture surgery: a prospective study

2020 ◽  
Vol 112 (3) ◽  
pp. 613-618 ◽  
Author(s):  
Lihong Hao ◽  
Jeffrey L Carson ◽  
Yvette Schlussel ◽  
Helaine Noveck ◽  
Sue A Shapses
Keyword(s):  
Vitamin D ◽  
Hip Fracture ◽  
Nutritional Status ◽  
Vitamin D Deficiency ◽  
Risk Index ◽  
Fracture Repair ◽  
Nutritional Risk ◽  
Hip Fracture Surgery ◽  
Nutritional Risk Index ◽  
Fracture Surgery

ABSTRACT Background Hip fractures are associated with a high rate of morbidity and mortality, and successful ambulation after surgery is an important outcome in this patient population. Objective This study aims to determine whether 25-hydroxyvitamin D [25(OH)D] concentration or the Geriatric Nutritional Risk Index (GNRI) is associated with mortality or rates of walking in a patient cohort after hip fracture surgery. Methods Patients undergoing hip fracture repair from a multisite study in North America were included. Mortality and mobility were assessed at 30 and 60 d after surgery. Serum albumin, 25(OH)D, and intact parathyroid hormone were measured. Patients were characterized according to 25(OH)D &lt;12 ng/mL, 12 to &lt;20 ng/mL, 20 to &lt;30 ng/mL, or ≥30 ng/mL. GNRI was categorized into major/moderate nutritional risk (&lt;92), some risk (92 to &lt;98), or in good nutritional status (≥98). Results Of the 290 patients [aged 82 ± 7 y, BMI (kg/m2): 25 ± 5], 73% were women. Compared with patients with &lt;12 ng/mL, those with higher 25(OH)D concentrations had higher rates of walking at 30 d (P = 0.031): 12 to &lt;20 ng/mL (adjusted OR: 2.61; 95% CI: 1.13, 5.99); 20 to &lt;30 ng/mL (3.48; 1.53, 7.95); ≥30 ng/mL (2.84; 1.12, 7.20). In addition, there was also greater mobility at 60 d (P = 0.028) in patients with higher 25(OH)D compared with the reference group (&lt;12 ng/mL). Poor nutritional status (GNRI &lt;92) showed an overall trend to reduce mobility (unadjusted P = 0.044 and adjusted P = 0.056) at 30 but not at 60 d. There was no association of vitamin D or GNRI with mortality at either time. Conclusions Vitamin D deficiency (&lt;12 ng/mL) is associated with reduced ambulation after hip fracture surgery, whereas GNRI also contributes to immobility but is a less reliable predictor. Mechanisms that can explain why vitamin D deficiency is associated with mobility should be addressed in future studies.

Sign in / Sign up

Export Citation Format

Share Document