Geriatric Nutritional Risk Index and Prognostic Nutritional Index as Predictors of One-Year Mortality in Older Patients After Hip Fracture Surgery: A Retrospective Cohort Study.

Wu, Wei; Zhu, Huanyi; Chen, Xiangxu; Gao, Yucheng; Tian, Chuwei; Rui, Chen; Xie, Tian; Shi, Liu; Li, Yingjuan; Rui, Yunfeng

Background: Malnutrition is a prevalent issue among older patients with hip fracture and is significantly associated with poor outcomes. The Geriatric Nutritional Risk Index (GNRI) and Prognostic Nutritional Index (PNI) are nutritional screening tools that may assist in predicting outcomes in older patients undergoing hip fracture surgery. This study aimed to evaluate the effects of GNRI and PNI on 1-year mortality after hip fracture surgery in older patients. Methods: This retrospective study included 577 patients aged 60 years and older with hip fractures treated surgically at a single center from January 2018 to December 2021. Nutritional status was evaluated using GNRI and PNI. The primary outcomes were 180-day and 1-year mortality, while secondary outcomes included short-term postoperative complications and length of stay. Univariate and multivariate analyses were performed to identify independent risk factors for 1-year mortality. Subgroup analysis was employed to identify potential population heterogeneity. Results: Patients with low GNRI and low PNI had significantly higher 1-year mortality rates and short-term postoperative complication rates compared to those with higher scores. Low GNRI was an independent risk factor for one-year mortality (95% CI 1.09 - 3.25, P = 0.022). Subgroup analyses revealed significant heterogeneity, with males patients and patients with ASA III-IV showing higher hazard ratios for 1-year mortality associated with low GNRI. Pulmonary infections and older age were also identified as independent risk factors for one-year mortality. Conclusion: This study demonstrated that low GNRI was the risk factor for 1-year mortality after hip fracture surgery in older patients.

MORTALITY risk factors; RISK assessment; HIP fractures; MALNUTRITION; T-test (Statistics); STATISTICAL significance; RESEARCH funding; NUTRITIONAL assessment; TREATMENT effectiveness; RETROSPECTIVE studies; MULTIVARIATE analysis; MANN Whitney U Test; DESCRIPTIVE statistics; SURGICAL complications; KAPLAN-Meier estimator; MEDICAL records; ACQUISITION of data; NUTRITIONAL status; STATISTICS; GERIATRIC nutrition; LENGTH of stay in hospitals; CONFIDENCE intervals; SURVIVAL analysis (Biometry); DATA analysis software; DISEASE risk factors; OLD age

Geriatric Orthopaedic Surgery & Rehabilitation, 2025, p1

2151-4585

Academic Journal

10.1177/21514593251340568