| 摘要 |
Background: The geriatric nutritional risk index (GNRI) calculated as 1.489 × albumin (g/dL) +41.7× (current body weight/ideal body weight) is useful in identifying high‑risk for malnutrition in elderly patients with subacute or chronic diseases. Given that trauma patients have sustained injuries in an acute condition, this study is designed to explore the association between GNRI on admission and outcomes in elderly and young adult patients with trauma.
Materials and Methods: From January 01, 2009, to December 31, 2019, a total of 1772 elderly and 2194 young adult trauma patients were categorized into four nutritional risk groups according to GNRI: high‑risk group (GNRI <82), moderate‑risk group (GNRI 82 to <92), low‑risk group (GNRI 92–98), and no‑risk group (GNRI >98). Propensity score‑matched patient cohorts were created in
different nutritional risk groups against the no‑risk group to minimize the confounding effects of sex, age, pre‑existing comorbidities, Glasgow Coma Scale score, and Injury Severity Score on outcome measurements. Primary outcome was in‑hospital mortality, and secondary outcome was the length of hospital stay.
Results: Young adult patients with trauma were comparable in pattern of mortality outcomes and hospital stays to that in elderly patients. Analysis of the selected propensity score‑matched patient cohorts revealed that both elderly and young adult patients in the high‑risk group had significantly higher odds
of mortality (elderly, odds ratio [OR], 6.5; 95% confidence interval [CI], 3.00‑14.03; P < 0.009; young adult, OR, 2.7; 95% CI, 1.45‑5.11; P = 0.001) and longer hospital stay (elderly, 21.5 days vs. 12.4 days, respectively, P < 0.001; young adults, 22.5 days vs. 14.1 days, respectively, P < 0.001) than those of the no‑risk group.
Conclusion: This study demonstrated that the GNRI could serve as a useful screening method to identify high‑risk malnutrition in acutely injured trauma patients, including not only the elderly trauma patients but also the young adult trauma patients. |
