Geriatric Nutritional Risk Index and 30-Day Postoperative Mortality in Geriatric Burn Patients

Area of Science:

• Geriatric Medicine
• Burn Surgery
• Nutritional Assessment

Background:

• Malnutrition significantly impacts morbidity and mortality in elderly patients.
• The Geriatric Nutritional Risk Index (GNRI) is a validated tool for identifying nutritional status.
• Preoperative nutritional status is crucial for surgical outcomes in geriatric populations.

Purpose of the Study:

• To investigate the association between preoperative Geriatric Nutritional Risk Index (GNRI) and 30-day mortality in geriatric burn patients undergoing surgery.
• To evaluate GNRI as a predictor of postoperative complications including sepsis, need for continuous renal replacement therapy (CRRT), major adverse cardiac events (MACE), and pneumonia.

Main Methods:

• Retrospective analysis of geriatric burn patients (≥ 65 years) who underwent surgery from 2012-2022.
• GNRI calculated using serum albumin and body weight relative to ideal body weight.
• Patients categorized into high (≥ 82) and low (< 82) GNRI groups. Multivariate Cox regression and Kaplan-Meier analyses performed.

Main Results:

• Low GNRI (< 82) was significantly associated with increased 30-day postoperative mortality (HR: 1.874, P=0.001).
• The low GNRI group exhibited significantly higher rates of 30-day mortality (HR: 2.677, P<0.001), sepsis (OR: 2.137, P=0.004), CRRT (OR: 1.919, P=0.025), MACE (OR: 1.680, P=0.043), and pneumonia (OR: 1.678, P=0.044).

Conclusions:

• Preoperative low GNRI is a significant predictor of adverse outcomes in geriatric burn patients.
• Low GNRI is linked to increased 30-day mortality, sepsis, CRRT, MACE, and pneumonia.
• Nutritional assessment using GNRI is vital for risk stratification and management of elderly burn patients.