Related Experiment Video

Updated: Sep 19, 2025

Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia
07:25

Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia

Published on: September 22, 2020

3.5K

Geriatric Nutritional Risk Index as a Predictor of Major Adverse Limb Events in Older Patients With Peripheral Artery

Xiaoyu Liu1, Xinjun Liu2, Qin Chen1,3

  • 1School of Nursing, Southwest Medical University, Luzhou, Sichuan, China.

Journal of Clinical Nursing
|June 16, 2025
PubMed

Insights

The Geriatric Nutritional Risk Index (GNRI) predicts major adverse limb events (MALE) in elderly patients with peripheral artery disease (PAD). A GNRI below 95 significantly increases MALE risk, highlighting the need for nutritional monitoring.

Area of Science:

  • Geriatric Medicine
  • Cardiovascular Research
  • Nutritional Science

Background:

  • The Geriatric Nutritional Risk Index (GNRI) is a known predictor of adverse outcomes in chronic diseases.
  • Its prognostic value for major adverse limb events (MALE) in elderly patients with peripheral artery disease (PAD) was previously unestablished.

Purpose of the Study:

  • To investigate the association between GNRI and the risk of MALE in elderly patients diagnosed with PAD.
  • To determine the prognostic utility of GNRI for MALE in this specific patient population.

Main Methods:

  • A multicenter, prospective study involving 1200 elderly patients (≥60 years) with PAD.
  • Patients were stratified based on GNRI values (At-risk: ≤98 vs. No-risk: >98).
  • Statistical analyses included Kaplan-Meier curves, multivariable Cox regression, and restricted cubic spline (RCS) modeling.

Main Results:

  • Among 1036 completers, 26.5% developed MALE during a mean follow-up of 18.9 months.
  • Higher MALE incidence was observed in the At-risk GNRI group (log-rank p < 0.001).
  • Adjusted Cox models showed a 45% increased MALE risk for the At-risk group (HR 1.45). RCS identified a non-linear L-shaped relationship, with MALE risk significantly decreasing with GNRI increases below 95 (p < 0.001).

Conclusions:

  • GNRI demonstrates a significant non-linear, L-shaped association with MALE risk in elderly PAD patients.
  • The prognostic utility is most critical for patients with GNRI below the 95 inflection point.
  • Routine GNRI monitoring and nutritional interventions for patients with GNRI < 95 are recommended to mitigate MALE risk.
Abstract

Keywords:
dose–response curvegeriatric nutritional risk indexmajor adverse limb eventsperipheral artery diseaseprediction

More Related Videos

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure05:16

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure

Published on: June 10, 2025

224
Glycemic Impact on Knee Osteoarthritis Symptoms on Physical, Radiographic, and Inflammatory Markers among Individuals Aged 50 and Over with Diabetes07:22

Glycemic Impact on Knee Osteoarthritis Symptoms on Physical, Radiographic, and Inflammatory Markers among Individuals Aged 50 and Over with Diabetes

Published on: March 7, 2025

386

Related Concept Videos

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
40
Peripheral Artery Disease IV: Nursing Management01:26

Peripheral Artery Disease IV: Nursing Management

 The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
48
Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
28
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
35
Peripheral Artery Disease I: Introduction01:30

Peripheral Artery Disease I: Introduction

Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
37
Atherosclerosis IV: Nursing Management01:23

Atherosclerosis IV: Nursing Management

Nursing management for a patient with arteriosclerosis involves a comprehensive approach focusing on lifestyle modification, disease monitoring, education, and symptomatic care. Here is an overview of effective nursing strategies:Assessment and Monitoring: Initial and ongoing assessments are crucial. Nurses must document the patient's medical history, including any hypertension, diabetes, hyperlipidemia, and other cardiovascular diseases. Assessments also cover family history and lifestyle...
69