Association Between Geriatric Nutritional Risk Index and Discharge Outcome after Elective Thoracic Endovascular Aortic Repair

Purpose To evaluate the utility of the Geriatric Nutritional Risk Index (GNRI) in predicting nonhome discharge (NHD) and delayed discharge after elective thoracic endovascular aortic repair (TEVAR). Methods The study population included patients undergoing elective simple TEVAR for intact thoracic aortic aneurysm or subacute or chronic aortic dissection between January 2009 and December 2022 and not experiencing neurological complications or re-interventions during hospitalization. The primary outcome measure was NHD and significantly delayed discharge. GNRI was calculated using the following equation: GNRI = 14.89 x serum albumin (g/dL) + 41.7 x (body mass index [kg/m(2)] / 22). A univariable logistic regression model was used to determine the odds ratio for GNRI. The predictive performance of GNRI was evaluated using the area under the receiver operating characteristic curve (AUC). Results A total of 229 patients were analyzed and the overall rate of the primary outcome was 5.7% (NHD, n = 6; delayed discharge, n = 10; both, n = 3). Patients with the primary outcome were more likely to have a lower GNRI (98 vs 103; P = .01) than those without. The logistic regression model showed that a high GNRI was protective against NHD (odds ratio, 0.38; 95% confidence interval, 0.18-0.76; P = .008). The AUC for GNRI was 0.710 (95% confidence interval, 0.602-0.821). The sensitivity, specificity, positive predictive value, and negative predictive value of GNRI < 92 were 23%, 89%, 11%, and 95%, respectively. Conclusions Preoperative evaluation of GNRI may be useful in predicting NHD and delayed discharge.