Analysis of the predictive value of three nutritional risk screening methods for surgical prognosis and recurrence of chronic subdural hematoma: A retrospective study.

ObjectivePatient nutritional status is an independent and crucial prognostic predictor; however, it is often overlooked in clinical practice. This study aimed to evaluate the value of three nutritional risk screening tools-Geriatric Nutritional Risk Index, Prognostic Nutritional Index, and Nutritional Risk Screening 2002-in predicting postoperative prognosis and recurrence in patients with chronic subdural hematoma.MethodAccording to the inclusion and exclusion criteria, a total of 153 patients with chronic subdural hematoma who were hospitalized and underwent surgical treatment at our hospital between December 2017 and October 2022 were retrospectively enrolled. General clinical data and laboratory test results were collected. The Nutritional Risk Screening 2002, Geriatric Nutritional Risk Index, and Prognostic Nutritional Index scores were assessed. Based on the modified Rankin scale scores, patients were divided into poor prognosis (score ≥3) and good prognosis (score <3) groups. According to the presence or absence of recurrence within 6 months of surgery, patients were classified into recurrence and nonrecurrence groups. General clinical data, laboratory results, and scores of three nutritional risk screening tools were evaluated. Receiver operating characteristic curves were plotted, and multivariate logistic regression analysis was performed.ResultsAmong the 153 patients, 13 (8.5%) had a poor prognosis. Compared with the good prognosis group, patients in the poor prognosis group were older, had higher fibrinogen levels, and had lower serum albumin and hemoglobin levels (p < 0.05). In total, 33 (21.6%) patients experienced recurrence. Compared with the nonrecurrence group, patients in the recurrence group had a higher percentage of monocytes (p < 0.05) and lower body mass index, serum albumin levels, and hemoglobin levels (p < 0.05). In the poor prognosis group, the rates of nutritional risk determined using the Geriatric Nutritional Risk Index, Prognostic Nutritional Index, and Nutritional Risk Screening 2002 were 46.2%, 69.2%, and 92.3%, respectively, which were significantly higher than those in the good prognosis group (p < 0.05). In the recurrence group, the nutritional risk rates determined using the abovementioned three tools were 42.4%, 51.5%, and 78.8%, respectively, all significantly higher than those in the nonrecurrence group (p < 0.05). Receiver operating characteristic curve analysis indicated that the Geriatric Nutritional Risk Index, Prognostic Nutritional Index, and Nutritional Risk Screening 2002 are predictive markers for both surgical prognosis and postoperative recurrence of chronic subdural hematoma. Moreover, multivariate logistic regression analysis identified the three tools as risk factors for poor prognosis and recurrence after surgery for chronic subdural hematoma (p < 0.05).ConclusionThree nutritional risk screening tools-the Geriatric Nutritional Risk Index, Prognostic Nutritional Index, and Nutritional Risk Screening 2002-were independently associated with both poor prognosis and recurrence of chronic subdural hematoma. Among them, the Geriatric Nutritional Risk Index showed the highest specificity in predicting poor prognosis, while the Nutritional Risk Screening 2002 demonstrated the highest specificity in predicting postoperative recurrence.