老年人营养风险指数和老年烧伤患者的30天术后死亡率
Jihion Yu1, Jun-Young Park1, Chan-Sik Kim1
1Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
The Journal of surgical research
|August 2, 2024
概括
老年烧伤患者的低老年营养风险指数 (GNRI) 预测了更高的30天死亡率和手术后的败血症和肺炎等并发症. 这突出了GNRI的重点.
科学领域:
- 老年医学 老年医学
- 烧伤手术 烧伤手术
- 营养评估 营养评估
背景情况:
- 营养不良显著影响老年患者的发病率和死亡率.
- 老年营养风险指数 (GNRI) 是确定营养状况的有效工具.
- 手术前的营养状况对于老年人群的手术结果至关重要.
研究的目的:
- 调查手术前老年营养风险指数 (GNRI) 与接受手术的老年烧伤患者的30天死亡率之间的关联.
- 评估GNRI作为术后并发症的预测因素,包括败血症,需要持续置换疗法 (CRRT),主要不良心脏事件 (MACE) 和肺炎.
主要方法:
- 对从2012年到2022年接受手术的老年烧伤患者 (≥65岁) 的回顾性分析.
- 使用血清白蛋白和体重相对于理想体重计算的GNRI.
- 患者分为高 (≥82) 和低 (<82) 的GNRI组. 进行多变量考克斯回归和卡普兰-梅尔分析.
主要成果:
- 低GNRI (<82) 与30天术后死亡率的增加显著相关 (HR:1.874,P=0.001).
- 低GNRI组的30天死亡率显着更高 (HR:2.677,P<0.001),败血症 (OR:2.137,P=0.004),CRRT (OR:1.919,P=0.025),MACE (OR:1.680,P=0.043) 和肺炎 (OR:1.678,P=0.044) 的发生率明显更高.
结论:
- 手术前低GNRI是老年烧伤患者不良结果的重要预测因素.
- 低GNRI与30天死亡率,败血症,CRRT,MACE和肺炎的增加有关.
- 使用GNRI进行营养评估对于风险分层和老年烧伤患者的管理至关重要.
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