Poor nutritional status is associated with incomplete functional recovery in elderly patients with mild traumatic brain injury

Bingcheng Zhu; Yunwei Ou; Xufei Guo; Weiming Liu; Liang Wu

doi:10.3389/fneur.2023.1131085

Poor nutritional status is associated with incomplete functional recovery in elderly patients with mild traumatic brain injury

Front Neurol. 2023 Apr 4:14:1131085. doi: 10.3389/fneur.2023.1131085. eCollection 2023.

Authors

Bingcheng Zhu¹, Yunwei Ou¹, Xufei Guo¹, Weiming Liu^{1

2

3}, Liang Wu¹

Affiliations

¹ Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
² China National Clinical Research Center for Neurological Diseases, Beijing, China.
³ Neurological Center, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China.

Abstract

Background: The geriatric nutritional risk index (GNRI) is a simple index for evaluating the nutrition status of elderly patients. Many investigations have demonstrated that this index is associated with the prognosis of several diseases. This study aims to identify the relationship between the GNRI and recovery in elderly mild traumatic brain injury (mTBI) patients.

Methods: A total of 228 mTBI patients older than 65 years were included in this study. mTBI was defined as an injury to the brain with a loss of consciousness of 30 min or less, a duration of posttraumatic amnesia of <24 h, and an admission Glasgow Coma Scale (GCS) score of 13-15. The Glasgow Outcome Scale Extended (GOSE), an outcome scale assessing functional independence, work, social activities, and personal relationships, was applied to assess the recovery of the patients. The clinical outcome was divided into complete recovery (GOSE = 8) and incomplete recovery (GOSE ≤ 7) at 6 months after the injury. Multivariate logistic regression was applied to evaluate the association between the GNRI and recovery of elderly mTBI patients, with adjustment for age, sex, hypertension, diabetes, and other important factors.

Results: The receiver operating curve (ROC) analysis demonstrated that the cutoff value of GNRI was 97.85, and the area under the curve (AUC) was 0.860. Compared to the patients with a high GNRI, the patients with a low GNRI were older, had a higher prevalence of anemia, acute subdural hematoma, and subarachnoid hemorrhage, had a higher age-adjusted Charlson Comorbidity Index value, and had lower levels of albumin, lymphocytes, and hemoglobin. Multivariable analysis showed that high GNRI was associated with a lower risk of 6-month incomplete recovery (OR, 0.770, 95% CI: 0.709-0.837, p < 0.001).

Conclusion: The GNRI has utility as part of the objective risk assessment of incomplete 6-month functional recovery in elderly patients with mTBI.

Keywords: elderly; geriatric nutritional risk index; mild traumatic brain injury; nutrition; nutritional supplement; prognosis.