Prognostic Value of Geriatric Nutritional Risk Index and Prognostic Nutritional Index in Geriatric Orthopedic Trauma Patients in the Surgical Intensive Care Unit

Aim: Malnutrition is associated with postoperative morbidity and mortality in geriatric patients. This study investigated the prognostic value of geriatric nutritional risk index (GNRI) and prognostic nutritional index (PNI) in geriatric orthopedic trauma patients. Material and Methods: Geriatric (>= 65 years old) patients followed in the surgical intensive care unit after orthopedic trauma surgery between June 2019 and June 2022 were evaluated retrospectively. Patients were classified into mortality and survivor groups. GNRI was calculated according to the ratio of serum albumin level and actual body weight to ideal body weight. PNI was obtained from serum albumin level and blood lymphocyte count. Results: The study included 371 patients. American Society of Anesthesiologists (ASA) IV status was significantly higher in the mortality group (p<0.001). AMean BMI, albumin, lymphocyte levels, PNI, and GNRI were significantly lower in the mortality group (p=0.009, p=0.008, p=0.030, p=0.001, Aand p=0.003, Arespectively). While the median Glasgow coma scale (GCS) Ascore was significantly lower, the median acute physiology and chronic health evaluation (APACHE)-II score and median injury severity score (ISS) Awere significantly higher in the mortality group (p<0.001 for all). Regression analysis revealed that ASA IV status, APACHE-II score, and ISS were independent predictors of mortality. In ROC curve analysis, the area under the curve (AUC) for GNRI was 0.660 (95% CI, 0.553-0.768), and the AUC for PNI was 0.654 (95% CI, 0.566-0.743). Conclusion: In geriatric orthopedic trauma patients, nutritional scores GNRI and PNI help in their values are not are similar.