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A prospective comparative study of the MNA-SF and GNRI nutritional screening tools in predicting infectious complications among elderly patients over 70 years undergoing posterior lumbar arthrodesis

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Abstract

Malnutrition is a risk factor for postoperative infectious complications of elderly patients undergoing posterior lumbar arthrodesis. At present, there is no gold standard for nutrition screening tools. We analyzed the value of predicting infectious complications among elderly patients over 70 years undergoing posterior lumbar arthrodesis by comparing the MNA-SF and GNRI. Demographic data, anthropometric measurements, serum albumin, surgical data and the occurrence of infectious complications and LOS were collected. Mini Nutritional Assessment short form (MNA-SF), Geriatric Nutritional Risk Index (GNRI) were performed within 24 h before surgery. Multivariable logistic regression analyses were used to identify predictors of infectious complications. The discriminatory performances of GNRI and MNA-SF scores for the occurrence of infectious complications were determined by receiver operating characteristic curves (ROC) analyses and the area under the curve (AUC). The study included 252 patients with a median age of 76.82 ± 6.41 years (range 70–84 years), and 142 patients (56.3%) were female. There were no significant differences in infectious complications (p = 0.236) and LOS (p = 0.580) among different GNRI categories. 27.3% malnourished patients evaluated by the MNA-SF suffered from infectious complications and 10.1% patients at risk of malnourished had infectious complications. Those patients had statistically significant higher prevalence of infectious complications (p = 0.002) and longer LOS (p = 0.023) than well-nourished patients. Multivariable analysis revealed that preoperative malnutrition and at risk of malnourished by the MNA-SF was significantly associated with infections. The area under the curve (AUC) of MNA-SF was 0.754, which was significantly high than AUC of GNRI (0.623) (Delong’s test, p = 0.033). This study demonstrated that MNA-SF is a simple and effective tool for predicting the risk of infectious complications in elderly patients undergoing posterior lumbar arthrodesis.

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Acknowledgements

We thank the staff at the Department of Orthopedics, Xuanwu Hospital Capital Medical University, and all the patients who participated in the study.

Funding

This study was sponsored by National Natural Science Foundation of China [No. 81672201 and No. 81871794]. The funders played no role in the design of this study, the collection, analysis and interpretation of data or preparation of the manuscript.

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Authors and Affiliations

  1. Department of Orthopedics, Xuanwu Hospital Capital Medical University, Beijing, China

    Zhong-En Li, Shi-Bao Lu, Chao Kong, Wen-Zhi Sun, Peng Wang & Si-Tao Zhang

  2. National Clinical Research Center for Geriatric Diseases, Beijing, China

    Zhong-En Li, Shi-Bao Lu, Chao Kong, Wen-Zhi Sun, Peng Wang & Si-Tao Zhang

  3. Capital Medical University, Beijing, China

    Zhong-En Li, Chao Kong, Wen-Zhi Sun & Peng Wang

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Contributions

ZEL was responsible for designing the search strategy, evaluating the articles, running statistical analysis and writing this article. CK was responsible for English editing. SBL was responsible for designing the protocol. WZS was responsible for interpreting results. PW and STZ were responsible for formatting the paper. All authors have read and approved the final version of the manuscript.

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Correspondence to Shi-Bao Lu.

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The authors declare that they have no competing interests.

Ethics approval

This study was reviewed and approved by the institutional review board following the declaration of Helsinki principles in Xuanwu Hospital Capital Medical University. The data collection process was entirely anonymous. The types of questions asked could not bring up any singular information that would make participants identifiable in the database and the results are presented in an aggregate manner.

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This study has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. No animals have been involved.

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A written informed consent was obtained from all participants of this study.

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Li, ZE., Lu, SB., Kong, C. et al. A prospective comparative study of the MNA-SF and GNRI nutritional screening tools in predicting infectious complications among elderly patients over 70 years undergoing posterior lumbar arthrodesis. Aging Clin Exp Res 33, 1947–1953 (2021). https://doi.org/10.1007/s40520-020-01725-7

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