老年营养风险指数与术后谵妄之间的关联：荟萃分析
Association between the geriatric nutritional risk index and postoperative delirium: a meta-analysis.
摘要(中文译文)
营养不良被认为是术后谵妄（POD）的重要促成因素。老年营养风险指数（GNRI）是一种基于血清白蛋白和体重的简易指标，近年来在手术患者中受到越来越多的评估。本荟萃分析旨在阐明GNRI与POD风险之间的关联。检索了PubMed、Embase和Web of Science数据库中评估分类GNRI与POD之间关联的观察性研究。采用随机效应模型计算合并风险比（RR）及95%置信区间（CI），并考虑异质性。共纳入12项队列研究，涉及12,332例手术患者。总体而言，低GNRI与POD风险显著增加相关（RR = 1.62，95% CI：1.34-1.96；I² = 27%）。亚组分析显示，在患者平均年龄 > 74岁的研究中，该关联强于平均年龄 ≤ 74岁的研究（亚组差异P = 0.02）；在使用GNRI截断值 < 98的研究中，该关联强于截断值 ≥ 98的研究（P = 0.04）。与单因素分析相比，使用多因素分析的研究中该关联较弱（P = 0.01）。Meta回归分析表明，GNRI截断值对合并效应有显著影响（P = 0.04）。漏斗图显示轻度不对称，而Egger检验无统计学意义（P = 0.11），剪补法分析产生了相似的合并估计值（RR = 1.54，95% CI：1.26-1.87）。低GNRI与手术患者POD风险增加相关，提示术前营养评估可能有助于识别该并发症的高危个体。本研究方案已在PROSPERO数据库前瞻性注册（注册号：CRD420261335609）。
Abstract
Malnutrition has been suggested as an important contributor to postoperative delirium (POD). The geriatric nutritional risk index (GNRI), a simple indicator based on serum albumin and body weight, has been increasingly evaluated in surgical patients. This meta-analysis aimed to clarify the association between GNRI and the risk of POD. PubMed, Embase, and Web of Science were searched for observational studies evaluating the association between categorized GNRI and POD. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using random-effects models accounting for heterogeneity. Twelve cohort studies involving 12,332 surgical patients were included. Overall, low GNRI was associated with a significantly increased risk of POD (RR = 1.62, 95% CI: 1.34-1.96; I² = 27%). Subgroup analyses showed a stronger association in studies with mean patient age > 74 years compared to ≤ 74 years ( for subgroup difference = 0.02) and in those using GNRI cutoffs < 98 compared to ≥ 98 ( = 0.04). The association was weaker in studies using multivariate analyses compared with univariate analyses ( = 0.01). Meta-regression indicated that GNRI cutoff values significantly influenced the pooled effect ( = 0.04). The funnel plot showed mild asymmetry, whereas Egger's test was not significant ( = 0.11), and trim-and-fill analysis produced a similar pooled estimate (RR = 1.54, 95% CI: 1.26-1.87). Low GNRI is associated with an increased risk of POD in surgical patients, suggesting that preoperative nutritional assessment may help identify individuals at higher risk for this complication. The study protocol was registered prospectively in the PROSPERO database (registration number: CRD420261335609).
如何引用
AMA
Dandan Han, Yingsi Liang, Qian Chen, Xinyu Wang, Xiao Chen. Association between the geriatric nutritional risk index and postoperative delirium: a meta-analysis.. Frontiers in psychiatry. 2026; doi:10.3389/fpsyt.2026.1826824.
APA
Dandan Han, Yingsi Liang, Qian Chen, Xinyu Wang, Xiao Chen (2026). Association between the geriatric nutritional risk index and postoperative delirium: a meta-analysis.. Frontiers in psychiatry. https://doi.org/10.3389/fpsyt.2026.1826824
GB/T 7714
Dandan Han, Yingsi Liang, Qian Chen, Xinyu Wang, Xiao Chen. Association between the geriatric nutritional risk index and postoperative delirium: a meta-analysis.[J]. Frontiers in psychiatry, 2026 doi:10.3389/fpsyt.2026.1826824.
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