GNRI、PNI、PAB与老年髋部骨折营养风险和营养不良预后的关系研究OACSTPCD

Objective To investigate the relationship between the geriatric nutritional risk index(GNRI),prognostic nutritional index(PNI),and prealbumin(PAB)levels and the nutritional risk and prognosis of malnutrition in elderly hip fracture patients.Methods A total of 240 elderly patients with hip fractures from January 2020 to December 2022 were se-lected,and clinical data were collected.They were followed up for one year after surgery and divided into nutritional risk group(≥3 scores)and normal nutrition group(＜3 scores)according to the nutritional risk screening score.The levels of PAB,GNRI,and PNI were compared before and after surgery,and the correlation of PAB with GNRI and PNI was analyzed.According to the occurrence of refeeding syndrome,the subjects were divided into good prognosis group and poor prognosis group.The receiver operating characteristic(ROC)curve analysis was used to analyze the prognostic value of preoperative PAB,GNRI,PNI,and their combination for malnutrition in patients.Results The levels of PAB,GNRI,and PNI in the nutritional risk group were lower than those in the normal nutrition group before surgery and at 3,6,9,and 12 months after surgery(P＜0.05,P＜0.01).The levels of PAB before surgery and at 3,6,9,and 12 months after surgery were signifi-cantly and positively correlated with PNI and GNRI at the corresponding time points(P＜0.05).The levels of PAB,GNRI,and PNI in the poor prognosis group were lower than those in the good prognosis group before surgery and at 3,6,9,and 12 months after surgery(P＜0.05,P＜0.01).The area under the ROC curve(AUC)of all indicators in combination for pre-dicting poor prognosis of elderly hip fracture patients(0.835)was much larger than that predicted by preoperative PAB,GNRI,and PNI alone(0.623,0.615,0.623,respectively).Conclusion The levels of GNRI,PNI,and PAB are closely related to the nutritional risk and prognosis of elderly hip fracture patients,and have certain predictive value for malnutrition in prognosis.