Malnutrition has been shown to be associated with poor prognosis in older surgical patients. Several tools are available for detecting malnutrition. But little is known about their ability to assess risks of postoperative adverse outcomes. The study aimed to compare the ability of the Geriatric Nutritional Risk Index (GNRI) and the Mini-Nutritional Assessment Short Form (MNA-SF) in predicting postoperative delirium (POD) and length of stay (LOS) among older non-cardiac surgical patients. Prospective study of 288 older non-cardiac surgical patients from the West China Hospital of Sichuan University. Preoperative nutritional status was assessed using the GNRI and MNA-SF, and patients were followed for the occurrence of POD and LOS. Multivariable logistic regression and linear regression analyses were used to identify predictors of these outcomes. The relative performance of the GNRI and MNA-SF as predictors of these outcomes were determined by Receiver Operating Characteristic curves (ROC) analyses and the area under the curve (AUC). Multivariable analysis revealed that preoperative malnutrition by the MNA-SF was significantly associated with POD. Linear regression analysis showed that preoperative low/high nutritional risk of the GNRI and malnutrition by the MNA-SF were independent predictors of prolonged LOS. Moreover, the area under the curve (AUC) of MNA-SF scores for POD was better than GNRI scores (AUC = 0.718, 95%CI: 0.64–0.80, P < 0.001 vs AUC = 0.606, 95%CI: 0.52–0.69, P = 0.019; Delong’s test, P = 0.006), but the AUC of GNRI scores and MNA-SF scores have no significant difference when predicting prolonged LOS (AUC = 0.611, 95%CI: 0.54–0.69, P = 0.006 vs AUC = 0.533, 95%CI: 0.45–0.62, P = 0.421; Delong’s test, P = 0.079). The MNA-SF was more effective than the GNRI at predicting the development of POD, but the two nutrition screening methods have similar performance in predicting prolonged LOS among older non-cardiac surgical patients.

中文翻译：

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老年非心脏外科手术患者的老年性营养风险指数与微型营养评估简短形式预测术后del妄和住院时间的前瞻性队列研究

营养不良与老年手术患者的不良预后有关。有几种工具可用于检测营养不良。但是对他们评估术后不良后果风险的能力知之甚少。这项研究旨在比较老年非心脏手术患者的老年营养风险指数（GNRI）和迷你营养评估简表（MNA-SF）预测术后del妄（POD）和住院时间（LOS）的能力。四川大学华西医院288例老年非心脏外科手术患者的前瞻性研究。使用GNRI和MNA-SF评估术前营养状况，并跟踪患者的POD和LOS发生情况。多变量逻辑回归和线性回归分析用于确定这些结果的预测因子。GNRI和MNA-SF作为这些结果的预测指标的相对性能由接收器工作特征曲线（ROC）分析和曲线下面积（AUC）确定。多变量分析显示，MNA-SF术前营养不良与POD显着相关。线性回归分析表明，术前低/高营养风险的GNRI和MNA-SF造成的营养不良是LOS延长的独立预测因素。此外，POD的MNA-SF得分的曲线下面积（AUC）优于GNRI得分（AUC = 0.718，95％CI：0.64-0.80，P <0.001 vs AUC = 0.606，95％CI：0.52-0.69 ，P = 0.019； Delong检验，P = 0.006），但在预测长期LOS时，GNRI评分的AUC和MNA-SF评分无显着差异（AUC = 0.611，95％CI：0.54–0.69，P = 0.006 vs AUC = 0.533，95％CI：0。45–0.62，P = 0.421；Delong检验，P = 0.079）。MNA-SF在预测POD发生方面比GNRI更有效，但两种营养筛查方法在预测老年非心脏外科手术患者长期LOS方面具有相似的性能。