Journal of shoulder and elbow arthroplasty · 2026
Lower Geriatric Nutritional Risk Index is associated with increased risk of acromial stress fracture following reverse total shoulder arthroplasty.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Stokes Leonard, Polam Vidhur, Sauvanell Yousy Martinez, Hoffman Tammy, Gosselin Michelle, Nahr Andrew, Denard Patrick J
Аннотация
BACKGROUND: Acromial and scapular spine stress fractures are serious complications following reverse total shoulder arthroplasty (rTSA), and patient-level risk factors may contribute to their development. The Geriatric Nutritional Risk Index (GNRI) is a validated marker of physiologic reserve. The purpose of this study was to evaluate the association between GNRI and post-operative stress fracture after rTSA. We hypothesized that lower GNRI would be associated with increased fracture risk.
METHODS: We performed a retrospective 1:2 age- and sex-matched case-control study of patients undergoing primary rTSA. Forty-five patients who developed post-operative acromial or scapular spine stress fracture were matched to 90 controls without fracture. Demographic variables collected included age, sex, body mass index, diagnosis, and comorbidities. GNRI was calculated pre-operatively and post-operatively and analyzed as a continuous variable and using predefined thresholds (<98, <103, <109). Conditional logistic regression adjusted for diagnosis and comorbidities. Receiver-operating characteristic analysis assessed discriminatory ability.
RESULTS: A total of 135 patients were included (mean age, 72.8 years; 53% female). Patients with stress fracture had lower pre-operative GNRI (107.4 ± 12.4 vs. 114.0 ± 13.9; P = .007) and post-operative GNRI (105.5 ± 14.9 vs. 114.8 ± 14.5; P = .001). Post-operative GNRI <109 was more common among fracture patients (60% vs. 30%; P = .001). In matched multivariable analysis, each 1-point increase in post-operative GNRI was associated with a 5% reduction in fracture odds (odds ratioOR, 0.95; 95% confidence interval [CI], 0.92-0.99; P = .015). Post-operative GNRI <109 was independently associated with fracture (odds ratio, 3.64; 95% CI, 1.02-13.02; P = .047). Receiver-operating characteristic analysis demonstrated moderate discrimination (area under the curve, 0.70; 95% CI, 0.60-0.79).
CONCLUSION: In this matched case-control analysis, lower post-operative GNRI was independently associated with increased risk of acromial and scapular spine stress fracture following rTSA. GNRI may serve as a practical perioperative risk stratification tool in patients undergoing reverse shoulder arthroplasty.
METHODS: We performed a retrospective 1:2 age- and sex-matched case-control study of patients undergoing primary rTSA. Forty-five patients who developed post-operative acromial or scapular spine stress fracture were matched to 90 controls without fracture. Demographic variables collected included age, sex, body mass index, diagnosis, and comorbidities. GNRI was calculated pre-operatively and post-operatively and analyzed as a continuous variable and using predefined thresholds (<98, <103, <109). Conditional logistic regression adjusted for diagnosis and comorbidities. Receiver-operating characteristic analysis assessed discriminatory ability.
RESULTS: A total of 135 patients were included (mean age, 72.8 years; 53% female). Patients with stress fracture had lower pre-operative GNRI (107.4 ± 12.4 vs. 114.0 ± 13.9; P = .007) and post-operative GNRI (105.5 ± 14.9 vs. 114.8 ± 14.5; P = .001). Post-operative GNRI <109 was more common among fracture patients (60% vs. 30%; P = .001). In matched multivariable analysis, each 1-point increase in post-operative GNRI was associated with a 5% reduction in fracture odds (odds ratioOR, 0.95; 95% confidence interval [CI], 0.92-0.99; P = .015). Post-operative GNRI <109 was independently associated with fracture (odds ratio, 3.64; 95% CI, 1.02-13.02; P = .047). Receiver-operating characteristic analysis demonstrated moderate discrimination (area under the curve, 0.70; 95% CI, 0.60-0.79).
CONCLUSION: In this matched case-control analysis, lower post-operative GNRI was independently associated with increased risk of acromial and scapular spine stress fracture following rTSA. GNRI may serve as a practical perioperative risk stratification tool in patients undergoing reverse shoulder arthroplasty.