老年人营养风险指数与腹主动脉瘤术后并发症发生的相关性分析

Correlation analysis of nutrition risk index in elderly patients with postoperative complications of abdominal aortic aneurysm

目的评估老年患者营养风险指数(GNRI)是否可以作为腹主动脉瘤腔内修复术(EVER)后发生并发症的评价指标。方法回顾性收集四川大学华西医院2011年1月至2017年12月期间372例行腹主动脉瘤EVAR术后患者,均为肾动脉下腹主动脉瘤,对患者的临床资料进行统计学分析,评估GNRI对EVER术后并发症的评判价值。结果在372例患者中,158例纳入GNRI异常组(GNRI≤98),214例纳入GNRI正常组(GNRI>98)。单因素分析结果显示:年龄(P=0.04)、饮酒(P=0.04)、血清白蛋白水平(P<0.001)、BMI(P<0.001)、GNRI(P=0.004)和中风(P<0.05)是影响腹主动脉瘤术后并发症的危险因素。多因素分析结果显示,术前GNRI[HR=0.687,95%CI为(0.487,0.968),P=0.032]异常是影响腹主动脉瘤术后并发症的独立危险因素。结论对于腹主动脉瘤腔内修复术的患者,GNRI是预测术后并发症的重要指标。

Objective To assess whether the geriatric nutritional risk index(GNRI)of elderly patients can be used as an evaluation index for complications after endovascular aneurysm repair(EVAR)of abdominal aortic aneurysm(AAA).Methods A total of 265 patients with EVAR who received abdominal aortic aneurysm between January 2011 to December 2017 were included in this study from West China Hospital of Sichuan University.All patients included in this study were subrenal arterial AAA.Statistical analysis of clinical data was performed.The value of GNRI in evaluating postoperative complications of EVER patients was evaluated.Results Of the 372 patients,158 were included in the GNRI abnormal group(GNRI≤98),and 214 were included in the normal group(GNRI>98).Univariate analysis showed that the age(P=0.04),drinking(P=0.04),serum albumin level(P<0.001),BMI(P<0.001),GNRI(P=0.004),and stroke(P<0.05)were risk factors that affects postoperative complications of AAA.Multivariate analysis showed that preoperative GNRI[HR=0.687,95%CI:(0.487,0.968),P=0.032]abnormality was one of the risk factors affecting postoperative complications of AAA.Conclusion For patients undergoing endovascular aneurysm repair of abdominal aortic aneurysm,the GNRI is one of the important indicator for predicting postoperative complications.