The potential of geriatric nutritional risk index in predicting the short-term outcome of intravenous thrombolysis in elderly individuals with acute cerebral infarction
Objective To evaluate the value of Geriatric Nutritional Risk Index(GNRI)in predicting the short-term outcome of elderly patients with acute ischemic stroke(AIS)after intravenous thrombolysis with alteplase.Methods A retrospective study was performed in 773 elderly AIS patients treated with alteplase intravenous thrombolytic therapy from July 2021 to January 2024 at Beichen Hospital in Tianjin,China.GNRI was calculated based on clinical data,and the nutritional status was assessed.Patients were evaluated with a modified Rankin score(mRS),and 575 patients were included in the poor outcome group(mRS score＞2)and 198 in the good outcome group(mRS score≤2).They were further classified into the low GNRI(GNRI＜92.107,n=388)and high GNRI(GNRI≥92.107,n=385)groups based on the optimal cut-off.The correlation of GNRI with short-term outcome of AIS after alteplase intravenous thrombolytic therapy was analyzed by logistic regression.Results Significantly lower GNRI was detected in the poor outcome group than the good outcome group(90.106[84.622-98.141]vs 90.722[82.239-100.055],P＜0.01).Multivariate logistic regression revealed that age,the National Institutes of Health Stroke Scale(NIHSS)score on admission,the Trial Org 10172 in Acute Stroke Treatment(TOAST)classification system of cardioembolism,outcome of bleeding,body mass index(BMI),and low GNRI were independent risk factors for the short-term poor outcome of AIS after alteplase intravenous thrombolytic therapy(P＜0.01).The receiver operating characteristic(ROC)curve showed that an area under the curve(AUC)of GNRI predicting the prognosis of intravenous thrombolysis in elderly AIS patients is 0.876(95％CI:0.845-0.907).Conclusion GNRI,as an independent risk factor for malnutrition and inadequate regression after intravenous thrombolysis in elderly AIS patients,is a promising indicator for assessing immune and nutritional status in this population.
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维普
