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Geriatric Nutritional Risk Index can predict postoperative delirium and hospital length of stay in elderly patients undergoing non‐cardiac surgery
Author(s) -
Zhao Yanli,
Xia Xin,
Xie Dongmei,
Liao Yulin,
Wang Yanyan,
Chen Ling,
Ge Ning,
Yue Jirong
Publication year - 2020
Publication title -
geriatrics and gerontology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 57
eISSN - 1447-0594
pISSN - 1444-1586
DOI - 10.1111/ggi.13963
Subject(s) - medicine , delirium , odds ratio , confidence interval , logistic regression , malnutrition , prospective cohort study , cohort study , surgery , emergency medicine , intensive care medicine
Aim Malnutrition is common in older patients and is associated with adverse outcomes. The Geriatric Nutritional Risk Index (GNRI) has been developed as an objective index to assess nutritional risk in these patients. However, there is limited evidence regarding the association between GNRI and postoperative delirium (POD) as well as length of stay (LOS) in surgical older patients. Therefore, our goal was to examine the impact of poor nutrition, evaluated by the GNRI, on POD and length of stay in older patients undergoing non‐cardiac surgery. Methods In this prospective cohort study, older patients undergoing non‐cardiac surgery from April to June of 2015 were included. Preoperative nutritional status was assessed by the GNRI within the first 48 h after hospital admission. The outcomes were POD and LOS. Multivariable logistic regression and linear regression analyses were used to assess the role of GNRI in predicting these outcomes. Results In the whole sample ( N = 288), the prevalence of severe/moderate (GNRI <92) and low (GNRI 92–98) nutritional risk was 15.6% and 29.5%, respectively. The median length of hospital stay was 14 days. Delirium was present in 49 patients (17%). A linear regression analysis showed that low (β = 4.56, 95% confidence interval [CI]: 2.18–6.94) and severe/moderate (β = 3.70, 95% CI: 0.74–6.65) nutritional risk were associated with prolonged LOS. Moreover, a multivariate analysis revealed that patients with severe/moderate nutritional risk were more likely to develop POD compared with those without (odds ratio = 2.56, 95% CI: 1.11–5.89). Conclusion Preoperative malnutrition, as assessed using the GNRI, predicted LOS and the development of POD in elderly non‐cardiac surgical patients. Geriatr Gerontol Int 2020; 20: 759–764 .