Exploring the relationship between malnutrition and the systemic immune-inflammation index in older inpatients: a study based on comprehensive geriatric assessment.

BACKGROUND: Malnutrition is a prevalent and major challenge among senior citizens, possibly due to the continual low-grade inflammatory state of the body. A novel inflammatory parameter, the systemic immune-inflammation index (SII), is highly valuable in evaluating and predicting the prognosis of a wide range of diseases. This study aims to explore the significance of the SII in assessing malnutrition in older inpatients. METHODS: This retrospective study included 500 senior hospitalized patients who met the inclusion and exclusion criteria from the Comprehensive Geriatric Assessment database of the First Hospital of Jilin University. The Mini-Nutritional Assessment (MNA) questionnaire was used to evaluate the nutritional status of patients. The SII was calculated using complete blood counts, and we performed natural logarithm transformation of the SII [ln(SII)]. Multivariable logistic regression analysis was used to identify the association between ln(SII) and malnutrition. To ensure the stability of the findings, a sensitivity analysis was conducted. RESULTS: The 500 patients had a mean age of 77.29 ± 9.85 years, and 68.6% were male. In accordance with the MNA, 30.4% of the patients were malnourished or at risk of malnutrition, and patients in this group had considerably greater levels of ln(SII) than patients with adequate nutrition (P < 0.001). The optimum ln(SII) cutoff value for patients with malnutrition or at risk of malnutrition was 6.46 (SII = 635.87) with 46.7% sensitivity and 80.2% specificity [95% CI: 0.613-0.721, AUC: 0.667, P < 0.001]. Multivariable logistic regression demonstrated that ln(SII) was an independent risk factor for the risk of malnutrition or malnutrition in older individuals (OR 3.984, 95% CI: 2.426-6.543, P < 0.001). Other metrics from the geriatric comprehensive assessment, including body mass index, calf circumference, fat ratio, activities of daily living and instrumental activities of daily living, and geriatric depression scale scores, were also independently correlated with nutritional status. CONCLUSIONS: According to our research, a high SII is an independent predictor of older inpatient malnutrition, and the SII aids in screening for malnutrition and may be a potential target for intervention. Comprehensive geriatric assessment parameters such as BMI, calf circumference, fat ratio, activities of daily living and depression were also linked to malnutrition.

Effects of herbal wet compresses on pain intensity, inflammatory factor levels, and quality of life in patients with pain.

OBJECTIVE: To investigate the pharmacological mechanisms and clinical effects of Traditional Chinese Medicine (TCM) wet compresses on pain, inflammation, and quality of life in patients with soft tissue injuries. METHODS: First, the network pharmacology of the active ingredients from TCM wet compresses were identified using the TCMSP (Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform) database (Common monkshood mother root, Two-toothed achyranthes root, Sour orange, Garden balsam stem, Safflower, Ground beetle, Zingiber, Haichow elsholtzia herb). Relevant targets for soft tissue injuries were obtained from GeneCards, revealing 20 key therapeutic targets. Pathway clustering highlighted inflammation-related pathways. Then we conducted clinical investigation by retrospectively analyzing the data of 80 patients with soft tissue injury treated in our hospital from January 2023 to December 2023. The data from healthy subjects who had physical examination in our hospital during the same period served as the control group (n=40). According to the treatment plan, the patients were divided into study group A (n=40, external treatment with Voltaalin ointment), and study group B (n=40, treatment with TCM wet compress). Pain intensity, inflammatory factor levels, and quality of life of the patients between the two groups were compared. RESULTS: Analysis of TCM wet compresses revealed 86 active ingredients and 259 intersecting targets, with key ingredients including sitogluside, beta-sitosterol, and quercetin. Key targets included IL-6, IL-1B, TNF, CXCL8, and IL10. Clinically, both patient groups showed significant reductions in pain and inflammatory markers, with greater improvements in study group B. In addition, quality of life improved notably post-treatment in study group B. CONCLUSION: TCM wet compress patches are effective in reducing pain, modulating inflammation, and improving the quality of life in patients with soft tissue injury. These findings support TCM wet compresses as a promising alternative treatment.