GNRI联合NLR对老年髋部骨折患者术后谵妄的预测价值  

Predictive value of GNRI combined with NLR in postoperative delirium in elderly patients with hip fracture

作　　者：邹燕[1] 邓婷智[1] 徐瑜[1] 郑庆[1] 伍媛[2] 惠珊 刘翠中[2] 危安[3] ZOU Yan;DENG Tingzhi;XU Yu;ZHENG Qing;WU Yuan;HUI Shan;LIU Cuizhong;WEI An(Department of Geriatrics,Hunan People's Hospital,Changsha 410002,China;不详)

机构地区：[1]湖南省人民医院(湖南师范大学附属第一医院)老年医学中心,长沙410002 [2]湖南省人民医院(湖南师范大学附属第一医院)全科医学科 [3]湖南省人民医院(湖南师范大学附属第一医院)超声医学科

出　　处：《山东医药》2023年第25期23-27,共5页Shandong Medical Journal

基　　金：湖南省保健专项资金科研课题(B2020-04)。

摘　　要：目的探讨老年营养风险指数(GNRI)联合中性粒细胞/淋巴细胞(NLR)对老年髋部骨折患者术后谵妄(POD)的预测价值。方法选择老年髋部骨折患者223例,均接受手术治疗,发生POD 51例(POD组)、未发生POD 172例(非POD组)。比较两组术前GNRI和NLR。收集老年髋部骨折患者术前基本资料、手术相关资料以及实验室检查资料,采用多因素Logistic回归模型分析老年髋部骨折患者发生POD的影响因素。采用受试者工作特征(ROC)曲线分析GNRI、NLR对老年髋部骨折患者POD的预测效能。结果POD组GNRI低于非POD组,NLR高于非POD组(P均<0.05)。多因素Logistic回归分析显示,年龄(OR=1.081,95%CI:1.019~1.146)、脑卒中(OR=2.712,95%CI:1.011~7.271)、NLR(OR=1.484,95%CI:1.021~2.156)为老年髋部骨折患者发生POD的独立危险因素(P均<0.05),而GNRI(OR=0.880,95%CI:0.825~0.940)则为其独立保护因素(P<0.05)。ROC曲线分析显示,GNRI、NLR单独和联合预测老年髋部骨折患者POD的曲线下面积(AUC)分别为0.755、0.746、0.824,GNRI联合NLR预测老年髋部骨折患者POD的AUC高于二者单独(Z分别为2.676、2.607,P均<0.01)。结论GNRI联合NLR对老年髋部骨折患者POD具有较高的预测价值,可作为老年髋部骨折患者POD的预测指标。Objective To investigate the predictive value of geriatric nutritional risk index(GNRI)combined with neutrophil/lymphocyte(NLR)in postoperative delirium(POD)in elderly patients with hip fracture.Methods Totally 223 elderly patients with hip fracture were selected and all of them received surgical treatment,including 51 patients with POD(POD group)and 172 patients without POD(non-POD group).Preoperative GNRI and NLR were compared between the two groups.The basic preoperative data,surgical data and laboratory examination data of elderly patients with hip frac⁃ture were collected,and the influencing factors of POD in elderly patients with hip fracture were analyzed by multivariate Logistic regression model.Receiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of GNRI and NLR on POD in elderly patients with hip fracture.Results GNRI in the POD group was significantly lower than that in the non-POD group,and NLR was significantly higher than that in the non-POD group(both P<0.05).Multi⁃variate Logistic regression analysis showed that age(OR=1.081,95%CI:1.019-1.146),stroke(OR=2.712,95%CI:1.011-7.271),and NLR(OR=1.484,95%CI:1.021-2.156)were independent risk factors for POD in elderly patients with hip fracture(all P<0.05),while GNRI(OR=0.880,95%CI:0.825-0.940)was an independent protective factor(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of GNRI and NLR alone and combined in predicting POD in elderly hip fracture patients were 0.755,0.746,and 0.824,respectively,and the AUC of GNRI combined with NLR in predicting POD in elderly hip fracture patients was significantly higher than that of GNRI or NLR alone(Z=2.676 and 2.607,respectively;all P<0.01).Conclusion GNRI combined with NLR has a high predictive value for POD in elderly patients with hip fracture,and can be used as a predictive index for POD in elderly patients with hip fracture.

关 键 词：术后谵妄 髋部骨折 老年营养风险指数 中性粒细胞/淋巴细胞 老年人 

分 类 号：R619[医药卫生—外科学]