Journal Article

Association between geriatric nutritional risk index and In-Hospital mortality in acute aortic dissection patients: a retrospective cohort study

Hong, Ni, Chen, Liangwan, Lin, Lingyu, Pan, Qiong, Li, Sailan, Lin, Yanjuan, Peng, Yanchun

2025

Overview

Background The impact of the geriatric nutritional risk index (GNRI) on the prognosis of patients with acute Stanford type A aortic dissection (AAAD) remains unclear. This study sought to explore the predictive value of GNRI for in-hospital mortality in patients with AAAD. Methods We conducted a retrospective analysis of patients who underwent surgery for AAAD from January 2014 to December 2022. Based on the median GNRI score, patients were stratified into high GNRI (> 103.7) and low GNRI (≤ 103.7) groups. Multivariate logistic regression analysis was used to assess the association between GNRI and in-hospital mortality. Results A total of 936 patients were included, with a mean age of 52.7 ± 11.6 years. The mean GNRI was 103.8 ± 11.3, and patients were stratified into low GNRI ( n  = 472, 50.4%) and high GNRI ( n  = 464, 49.6%) groups. The low GNRI group had a significantly higher in-hospital mortality rate than the high GNRI group (23.1% vs. 17.5%, P  = 0.032). Multivariate logistic regression identified GNRI ≤ 103.7 as an independent risk factor for in-hospital mortality (OR = 2.037, 95%CI:1.110–3.740, P  = 0.022). CPB time (OR = 1.005, 95%CI: 1.001–1.009, P  = 0.022), and lactate levels (OR = 1.221, 95%CI: 1.144–1.302, P  < 0.001) were also independent risk factors for in-hospital mortality. The AUC of the logistic model was 0.811. Conclusion The GNRI is a validated nutritional assessment tool, and AAAD patients with a GNRI ≤ 103.7 havesignificantly higher in-hospital mortality rate. These findings highlight the importance of preoperative nutritional assessment and optimization to improve outcomes for AAAD patients.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Acute Disease / Adult / Age Factors / Aged / Angiology / Aortic Aneurysm - diagnosis / Aortic Aneurysm - diagnostic imaging / Aortic Aneurysm - mortality / Aortic Aneurysm - physiopathology / Aortic Aneurysm - surgery / Aortic dissection / Aortic Dissection - diagnosis / Aortic Dissection - diagnostic imaging / Aortic Dissection - mortality / Aortic Dissection - physiopathology / Aortic Dissection - surgery / Blood Transfusion Medicine / Body mass index / Cardiac Surgery / Cardiology / Care and treatment / China / Complications and side effects / Creatinine / Decision Support Techniques / Diabetes / Dissecting aneurysm / Dissection / Esophagus / Female / Foreign bodies / Geriatric Assessment / Geriatric nutritional risk index / Geriatrics / Hospital Mortality / Hospital patients / Hospitals / Humans / Hypertension / In-hospital mortality / Infectious diseases / Internal Medicine / Male / Malnutrition / Malnutrition - diagnosis / Malnutrition - mortality / Malnutrition - physiopathology / Medical prognosis / Medicine / Medicine & Public Health / Middle Aged / Mortality / Nutrition / Nutrition Assessment / Nutritional Status / Patients / Perioperative management in cardiac surgery / Predictive Value of Tests / Product/Service Evaluations / Prognosis / Proteins / Regression analysis / Retrospective Studies / Risk Assessment / Risk Factors / Surgery / Time Factors / Treatment Outcome / Ventilators / Vital signs