Does the Geriatric Nutritional Risk Index Play a Predictive Role in Postoperative Atrial Fibrillation and Outcomes in Cardiac Surgery?

Objectives: Malnutrition is associated with adverse surgical outcomes. The Geriatric Nutritional Risk Index, a nutritional screening tool, could be a predictor of postoperative atrial fibrillation and outcomes in cardiac surgery.Design: The authors enrolled 292 patients who underwent cardiac surgery and showed postoperative atrial fibrillation during hospitalization, and assessed mortality and readmission during a 90-day follow-up period.Setting: A large academic hospital in China. Participants:Participants were divided into low-risk (Geriatric Nutritional Risk Index <98) and no-risk malnutrition groups (Geriatric Nutri-tional Risk Index >98).Interventions: Univariate and multivariate logistic regression analyses were used to validate the role of the Geriatric Nutritional Risk Index in predicting postoperative atrial fibrillation. Kaplan -Meier analysis was used to examine the effect of Geriatric Nutritional Risk Index scores on mortality and readmission after cardiac surgery.Measurements and Main Results: A total of 136 patients were in the low-risk malnutrition group. Postoperative atrial fibrillation was more common in the low-risk group (63.2% v 28.8%, p < 0.001). Duration of intensive care unit stays and hospitalization were significantly longer than in the no -risk group (44 [43] v 39 [47] hours, p < 0.001; 18 [7] v 15 [6] days, p < 0.001). Multivariate analysis showed that Geriatric Nutritional Risk Index, age, and NYHA class independently predicted postoperative atrial fibrillation. Kaplan -Meier analysis showed that 90-day all-cause readmission, but not 90-day all-cause mortality, was different between groups based on the Geriatric Nutritional Risk Index (log-rank p < 0.001, log-rank p = 0.09).Conclusions: The easily accessible Geriatric Nutritional Risk Index used for nutritional assessment before cardiac surgery has a predictive role in postoperative atrial fibrillation, and is related to short-term readmission.(c) 2022 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)