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

Abstract

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.