Geriatric nutritional risk index predicts postoperative delirium in elderly: A meta-analysis

Siye Xie; Qi Wu

doi:10.15537/smj.2024.45.9.20240216

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Figure 1
- Flowchart of the study.
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Figure 2
- Meta-analysis of the risk of POD in the patients with a moderate or high risk of malnutrition versus those with low risk or no malnutrition. CI: confidence interval, POD: postoperative delirium

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Table 1

- Basic characteristics of included studies (n=6).

Included study	Year	Country	Age (Year-old)		Sample		Surgery	POD case and percentage
Included study	Year	Country	Study arm	Control arm	Study arm	Control arm	Surgery	Study arm	Control arm
Geng et al ⁽¹⁶⁾	2022	China	72.6±5.8	71.3±5.0	239	676	Non-cardiac surgery	38 (15.9)	66 (9.8)
Takahashi et al ⁽¹⁷⁾	2021	Japan	70 (64-75)		205	270	NSCLC surgery	8 (3.9)	9 (3.3)
Zhao et al ⁽²⁸⁾	2020	China	75 (73-79)	Low risk 75 (72-78), no risk 74 (71-77)	45	243	Non-cardiac surgery	14 (31.1)	35 (14.4)
Lee et al ⁽¹⁹⁾	2019	England	Moderate risk 70.3±16.2; high risk 67±16.7	65±16.9	856	1212	SBO surgery	62(19.8)	38 (3.1)
Wang et al ⁽²⁰⁾	2019	China	Moderate risk 46.1+11.6; High risk 44.5+12.7	Low risk 45.2+13.2; no risk 45.3+12.7	46	102	Cardiac surgery	3 (13.1)	5 (10.0)
Kushiyama et al ⁽²¹⁾	2018	Japan	80.3±3.8	79.0±3.6	190	158	Gastrectomy	2 (1.3)	0

1: GNRI = (1.489×serum albumin [g/L]) + (41.7×[current body weight / ideal body weight]); GNRI diagnostic criteria with Bouillanne O is high risk (GNRI<82), moderate risk (82≤GNRI<92), low risk (92≤GNRI≤98), and no risk (GNRI >98). GNRI: geriatric nutritional risk index SBO: small bowel obstruction, NSCLC: non-small cell lung cancer, POD: postoperative delirium

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Table 2

- Newcastle Ottawa Scale Rating of included studies

Included study	Selection of subjects				Outcome of measurement				Total score
Included study	Representativeness of the exposed cohort	Representativeness of the control cohort	Ascertainment of the exposure	Lack of observatory indicator for the outcome of the study	Comparability between exposed and control cohorts	Independent evaluation of blinding	Sufficiency of follow-up	Completeness of follow-up	Total score
Geng et al ⁽¹⁶⁾	1	1	1	1	2	0	1	1	8
Takahashi et al⁽¹⁷⁾	1	1	1	1	2	1	1	1	9
Zhao et al⁽¹⁸⁾	1	1	1	1	2	0	1	1	8
Lee et al⁽¹⁹⁾	1	1	1	1	2	1	1	1	9
Wang et al⁽²⁰⁾	1	1	1	1	2	0	1	1	8
Kushiyama et al⁽²¹⁾	1	1	1	1	2	1	1	1	9