Association Between Geriatric Nutritional Risk Index and Discharge Outcome after Elective Thoracic Endovascular...

Area of Science:

• Vascular Surgery
• Geriatric Medicine
• Nutritional Assessment

Background:

• Elective thoracic endovascular aortic repair (TEVAR) is a common procedure for aortic aneurysms and dissections.
• Predicting patient outcomes after TEVAR is crucial for optimizing care and resource allocation.
• Nutritional status is increasingly recognized as a factor influencing surgical outcomes.

Purpose of the Study:

• To assess the predictive value of the Geriatric Nutritional Risk Index (GNRI) for nonhome discharge (NHD) and delayed discharge following elective TEVAR.
• To determine if GNRI can serve as a useful preoperative risk stratification tool in this patient population.

Main Methods:

• A retrospective analysis of 229 patients undergoing elective simple TEVAR between 2009 and 2022.
• GNRI was calculated using serum albumin and body mass index.
• Univariable logistic regression and receiver operating characteristic (ROC) curve analysis were employed to evaluate GNRI's predictive performance.

Main Results:

• The primary outcome (NHD or delayed discharge) occurred in 5.7% of patients.
• Patients experiencing the primary outcome had significantly lower GNRI scores (98 vs. 103, P=.01).
• A higher GNRI was associated with a reduced risk of NHD (OR, 0.38; P=.008), with an Area Under the Curve (AUC) of 0.710 for GNRI.

Conclusions:

• Preoperative GNRI is a valuable tool for predicting nonhome discharge and delayed discharge after elective TEVAR.
• Incorporating GNRI into preoperative assessments may help identify high-risk patients and guide perioperative management.