手术前的营养状况可以是评估脊柱手术的老年患者生物年龄的参数之一吗? 一个倾向性得分匹配的分析

Yuki Kinoshita¹, Koji Tamai, Makoto Oka

¹Department of Orthopedics, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.

Spine

|March 9, 2026

概括

经过脊柱手术的老年患者的手术前营养不良,由老年营养风险指数 (GNRI) 确定,与较差的健康相关生活质量 (HRQOL) 结果有关. GNRI可以表明生物年龄,并指导手术决策.

科学领域:

老年医学老年医学
外科手术的结果
营养评估营养评估

背景情况:

接受手术的老年患者需要考虑生物年龄和时间年龄.
手术前的营养状况可能会影响术后与健康相关的生活质量 (HRQOL).
营养状况与脊柱手术后HRQOL改善之间的假设关联,独立于时间年龄.

研究的目的:

评估手术前营养指数与脊椎手术后老年患者手术后HRQOL之间的关联.
研究营养状况对长期HRQOL结果的预测价值.

主要方法:

对600名经过脊髓手术的老年患者 (≥60岁) 进行了回顾性队列研究.
使用老年营养风险指数 (GNRI),预后营养指数 (PNI) 和控制营养状况 (CONUT) 评分评估营养状况.
使用倾向性匹配得分来比较营养不良和对照组之间的HRQOL (EQ-5D-5L) 变化,以关键共变量进行调整.

主要成果:

低的手术前GNRI与1年和2年的术后HRQOL得分较低显著相关.
在PNI或CONUT和术后HRQOL之间没有发现显著的关联.
低GNRI患者在手术后的HRQOL中获得临床重要差异的可能性较低.

结论:

通过GNRI评估的手术前营养不良是老年脊柱手术患者手术后HRQOL受损的独立预测因素.
在这个人群中,GNRI可以作为一个有价值的营养标记物和生物年龄的替代品.
强调营养状况在优化老年患者手术结果和生活质量的重要性.

关键词:

在 EQ-5D-5L 中.在GNRI中,GNRI是GNRI.生物年龄生物年龄控制营养状况的控制年长的病人,老年患者.老年人的营养风险指数.与健康相关的生活质量.营养不良营养不良营养不良营养状态营养状况预后营养指数的预后.倾向性得分匹配的比分匹配脊柱外科手术脊柱外科手术

相关概念视频

01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

302

In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...

302

01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

307

Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are...

307

01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

306

01:15

Drug Dosing: Geriatric Patients

339

Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...

339

01:23

Peripheral Artery Disease V: Postoperative Nursing Management

494

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...

494

01:15

Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding

1.4K

Enteral nutrition encompasses various methods of delivering nutrition directly to the gastrointestinal (GI) tract, bypassing traditional oral intake. It is particularly beneficial for patients who cannot eat by mouth but have a functioning digestive system. Key methods include nasointestinal feeding, gastrostomy, and jejunostomy, each suited to different clinical scenarios based on the patient's needs and condition.
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...

1.4K