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J Wrist Surg
DOI: 10.1055/s-0044-1782239
Scientific Article

Low Geriatric Nutritional Risk Index Predicts Early Complications following Distal Radius Fracture Open Reduction Internal Fixation

Steven H. Liu
1   Department of Orthopaedics, Stony Brook University, Stony Brook, New York
,
Patricia Cerri-Droz
1   Department of Orthopaedics, Stony Brook University, Stony Brook, New York
,
Rachel A. Loyst
1   Department of Orthopaedics, Stony Brook University, Stony Brook, New York
,
Zachary Warheit
1   Department of Orthopaedics, Stony Brook University, Stony Brook, New York
,
David E. Komatsu
1   Department of Orthopaedics, Stony Brook University, Stony Brook, New York
,
Edward D. Wang
1   Department of Orthopaedics, Stony Brook University, Stony Brook, New York
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Abstract

Background While previous studies have investigated the association between the Geriatric Nutritional Risk Index (GNRI) and functional outcomes following distal radius fracture (DRF), no large-scale studies have investigated the associations between GNRI and postoperative outcomes following DRFs.

Objectives The purpose of this study is to investigate the association between GNRI, a simple multifaceted measure of malnutrition risk, and 30-day postoperative complications following DRF open reduction internal fixation (ORIF).

Materials and Methods The American College of Surgeons National Surgical Quality Improvement Program database was queried for patients who underwent DRF ORIF from 2015 to 2021. Patients were organized into three groups based on preoperative GNRI: normal/reference (GNRI > 98), moderate malnutrition (92 ≤ GNRI ≤ 98), and severe malnutrition (GNRI < 92). Logistic regression analysis was conducted to investigate the relationship between preoperative GNRI and postoperative complications.

Results Severe malnutrition was independently associated with a greater likelihood of any complication (odds ratio [OR]: 3.22, 95% confidence interval [CI]: 2.48–4.17; p < 0.001), sepsis (OR: 15.41, 95% CI: 1.66–143.32; p = 0.016), cardiac arrest or myocardial infarction (OR: 20.58, 95% CI: 1.62–261.26; p = 0.020), pulmonary embolism (OR: 9.40, 95% CI: 1.76–50.11; p = 0.009), surgical site infection (OR: 7.73, 95% CI: 1.99–30.02; p = 0.003), nonhome discharge (OR: 2.55, 95% CI: 1.87–3.49; p < 0.001), readmission (OR: 2.47, 95% CI: 1.47–4.14; p < 0.001), and length of stay > 2 days (OR: 3.51, 95% CI: 2.67–4.62; p < 0.001).

Conclusions Malnutrition is an independent significant predictor of early complications following DRF ORIF.

Level of Evidence Level III; retrospective cohort comparison; prognosis study.

Keywords

distal radius fracture - geriatric - malnutrition - open reduction internal fixation - Geriatric Nutritional Risk Index

Note

This is an observational study. It was exempt from approval by our University's Institutional Review Board.




Publication History

Received: 07 November 2023

Accepted: 06 February 2024

Article published online:
08 March 2024

© 2024. Thieme. All rights reserved.

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