老年人营养风险指数预测高龄髋关节置换术后并发症的价值

Value of geriatric nutritional risk index in predicting complications after hip replacement in elderly patients

目的探讨老年人营养风险指数(GNRI)预测高龄髋关节置换术后并发症的价值。方法前瞻性选取2020年1月至2022年2月在唐山市第二医院行髋关节置换术的高龄患者271例,根据术后1个月内并发症发生情况分为发生组(n=28)和未发生组(n=243)。采用多因素logistic回归分析导致术后并发症发生的危险因素;绘制受试者工作特征曲线(ROC)分析GNRI对术后并发症的预测价值。结果发生组年龄、术中输血例数占比、术中出血量、手术时间及白细胞、肌酐、中性粒细胞、单核细胞均高于未发生组,GNRI、淋巴细胞、血红蛋白水平低于未发生组(P<0.05);多因素logistic回归分析显示,术中输血、术中出血量高、GNRI低、手术时间长及血红蛋白水平低是导致术后并发症发生的危险因素(P<0.05);ROC曲线显示,GNRI预测术后发生并发症的曲线下面积为0.892。结论GNRI是影响高龄患者髋关节置换术后发生并发症的独立危险因素,并具有较高的预测价值。

Objective To explore the value of geriatric nutritional risk index(GNRI)in predicting complications after hip arthroplasty.Methods A total of 271 elderly patients undergoing hip arthroplasty in the Second Hospital of Tangshan from January 2020 to February 2022 were prospectively selected and divided into the occurrence group(n=28)and non-occurrence group(n=243)according to the occurrence of complications within one month after surgery.Multivariate logistic regression was used to analyze the risk factors leading to postoperative com⁃plications.Receiver operating characteristic curve(ROC)was plotted to analyze the predictive value of GNRI for postoperative complications.Results Age,proportion of intraoperative transfusion cases,intraoperative blood loss,operative time,leukocytes,creatinine,neutrophils and monocytes in the occurrence group were higher than those in the non-occurrence group;GNRI,lymphocyte,and hemoglobin levels were lower than those in the non-occurrence group(P<0.05).Multivariate logistic regression analysis showed that intraoperative blood transfusion,high intraoperative blood loss,low GNRI,long operation time and low hemoglobin level were the risk factors for postoperative complications(P<0.05).The ROC curve showed that GNRI predicted that the AUC of postoperative complications was 0.892.Conclusions GNRI is an indepen⁃dent risk factor for complications after hip replacement in elderly patients,which has high predictive value.