ArticleBMC musculoskeletal disorders2026
Malnutrition drives re-revision and mortality in elderly revision arthroplasty: the prognostic value of GNRI.
Article in BMC musculoskeletal disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe impact of perioperative malnutrition on long-term outcomes in elderly revision arthroplasty remains underexplored. This study aimed to (1) evaluate the association between preoperative GNRI and the risk of re-revision; and (2) assess its prognostic value for all-cause mortality.
methodsA retrospective cohort of 771 patients aged ≥ 60 years undergoing hip or knee revision arthroplasty (2008–2024) was analyzed. GNRI was calculated preoperatively and assessed as both continuous and categorical variables. Primary outcomes were all-cause re-revision and all-cause mortality. Logistic regression, Cox models, restricted cubic splines, and ROC analysis were applied.
resultsLower GNRI was independently associated with increased risks of re-revision (OR per unit decrease = 1.05; P = 0.005) and mortality (HR for GNRI < 101.21 = 2.14; P = 0.020). RCS showed nonlinear relationships, with inflection points around GNRI = 105. GNRI demonstrated moderate predictive performance for both outcomes (AUC: 0.68 for re-revision, 0.65 for mortality).
conclusionsPreoperative malnutrition, as measured by GNRI, predicts both re-revision and all-cause mortality in elderly revision arthroplasty patients. Nutritional risk stratification may help guide perioperative management. LEVEL OF EVIDENCE: Level III, prognostic study.
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