Application of geriatric nutritional risk index in predicting postoperative delirium in elderly patients undergoing noncardiac surgery
Objective To investigate the application value of geriatric nutritional risk index(GNRI)in predicting postoperative delirium(POD)in elderly patients after noncardiac surgery.Methods A retrospective analysis was conducted on 479 elderly patients undergoing noncardiac surgery under general anesthesia in Xuzhou Central Hospital from October 2022 to September 2023.According to clinical outcomes,they were divided into a delirium group(n=140)and a non-delirium group(n=339).Basic information,preope-rative laboratory indicators and results of evaluation scales were compared between the two groups.Multivariate logistic regression anslysis was applied to identify the independent risk factors for POD,and receiver operating characteristic(ROC)curve was drawn to evaluate the value of GNRI and its fitting model in predicting POD in elderly patients undergoing noncardiac surgery.SPSS statistics 26.0 and R4.2.3 were employed for statistical analysis.Student's t test,Mann-Whitney U test or χ2 test was employed for intergroup comparison depending on data type.Results Significant differences were observed between two groups in terms of age,body mass index(BMI),GNRI,education level,admission to intensive care unit,operative category,degree of anaemia,Charlson comorbidity index(CCI),operation time,intraoperative fluid balance,and preoperative hemoglobin and uric acid levels and neutrophil to lymphocyte ratio(NLR).Multivariate logistic regression showed that GNRI,age,CCI,NLR,and operation time were independent risks for POD in the elderly patients(P<0.05).Based on the results of multivariate logistic regression analysis,the fitted Model 3 had an ROC area under the curve value of 0.893(95％CI 0.862-0.919)in predicting POD,with a specificity of 81.4％and a sensitivity of 79.4％.Conclusion GNRI is an independent predictor of POD in elderly patients undergoing noncardiac surgery,and has good predictive value for the occurrence of POD.
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