{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T20:57:10Z","timestamp":1793739430518,"version":"4.6.1"},"reference-count":60,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The Geriatric Nutritional Risk Index (GNRI) is widely applied to evaluate malnutrition in older adults, yet its relevance in spinal deformity surgery is unclear. This study examined the relationship between nutritional status before surgery, as assessed by GNRI, and postoperative outcomes in geriatric patients undergoing spinal deformity surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The 2008-2023 ACS-NSQIP database was queried for patients aged \u226565 years who underwent spinal deformity surgery. Patients were stratified by GNRI score: normal (&gt;98), malnourished (92-98), or severely malnourished (&lt;92). The independent association and predictive value of GNRI were assessed in comparison to the 5-item modified Frailty Index (mFI-5) and chronological age for perioperative outcomes, including length of stay, non-home discharge, and 30-day postoperative complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 2186 patients were included: 1705 (78%) had normal nutrition, 332 (15.2%) were malnourished, and 149 (6.8%) were severely malnourished. Malnourished status was independently associated with significantly greater odds of wound disruption (OR 3.3,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .014), prolonged mechanical ventilation (OR 2.2,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.019), postoperative transfusion (OR 1.5,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .001), increased transfusion volume (coefficient 0.452,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .044), and non-home discharge (OR 1.6,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) compared to normal patients. In receiver operating characteristic analyses, GNRI demonstrated superior discriminatory ability compared with mFI-5 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.394,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .645,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .179,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .113,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .014,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .233) and age (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .277,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .074,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .039,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .167,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) for predicting wound disruption, superficial surgical site infection, prolonged mechanical ventilation, unplanned intubation, the need for transfusion, and prolonged hospitalization.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Preoperative malnutrition, defined by GNRI, is correlated with a greater risk of adverse outcomes following spinal deformity surgery in older adults, highlighting the importance of incorporating nutritional assessment into preoperative evaluation in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682261436347","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T18:01:03Z","timestamp":1774893663000},"page":"3422-3436","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Geriatric Nutritional Risk Index as a Predictor of Outcomes After Spinal Deformity Surgery in Elderly Patients"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1042-8580","authenticated-orcid":false,"given":"Ataollah","family":"Shahbandi","sequence":"first","affiliation":[{"name":"Medical College of Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Wojcik","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saman","family":"Shabani","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,30]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2018.03.022"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2022.12.014"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyz454"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyx218"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.3171\/2023.5.SPINE23456"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyx578"},{"issue":"11","key":"e_1_3_5_8_2","first-page":"1219","article-title":"Risk factors for and prediction of early thromboembolic disease following adult spinal deformity surgery: an analysis of > 7,400 patients with spinal deformity","volume":"107","author":"Gallagher DO","year":"2025","unstructured":"Gallagher DO, Bondar K, Hirase T, et al. 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