Shoulder arthroscopy in elderly patients: malnutrition and early postoperative outcomes.

ABSTRACT

Background: This study investigates the association between the Geriatric Nutritional Risk Index (GNRI), a simple, readily available malnutrition risk index, and 30-day postoperative complications following shoulder arthroscopy. Methods: The American College of Surgeons National Surgical Quality Improvement Program database was used to identify all patients aged ≥65 years who underwent shoulder arthroscopy between 2015 and 2021. The study population was indexed into 3 cohorts of preoperative GNRI normal/reference (GNRI >98), moderate malnutrition (92≤ GNRI ≤98), and severe malnutrition (GNRI <92). Multivariate logistic regression analysis was conducted to investigate the connection between preoperative GNRI and postoperative complications. Results: Severe malnutrition was independently significantly associated with a greater likelihood of any complication (odds ratio [OR] 11.70, 95% confidence interval [CI] 8.58-15.94; P < .001), sepsis (OR 26.61, 95% CI 10.86-65.21; P < .001), septic shock (OR 7.53, 95% CI 1.56-36.32; P = .012), blood transfusions (OR 25.38, 95% CI 6.40-100.59; P < .001), pulmonary embolism (OR 7.25, 95% CI 1.27-41.40; P = .026), surgical site infection (OR 22.08, 95% CI 7.51-64.97; P < .001), nonhome discharge (OR 15.75, 95% CI 9.83-25.23; P < .001), readmission (OR 2.69, 95% CI 1.52-4.74; P < .001), unplanned reoperation (OR 6.32, 95% CI 2.23-17.92; P < .001), length of stay >2 days (OR 23.66, 95% CI 16.25-34.45; P < .001), and mortality (OR 14.25, 95% CI 2.89-70.40; P = .001). Conclusion: GNRI-based malnutrition is strongly predictive of perioperative complications following shoulder arthroscopy in geriatric patients and has utility as an adjunctive risk stratification tool.