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The geriatric nutritional risk index (GNRI) predicts adverse outcomes in chronic diseases, but its prognostic value for major adverse limb events (MALE) in elderly patients with peripheral artery disease (PAD) remains unverified; thus, this study aimed to establish the association between GNRI and MALE.
A multicenter, prospective study.
From January 2021 to August 2022, 1200 patients with PAD aged ≥ 60 years were enrolled. Patients were stratified by GNRI value (At-risk group: ≤ 98 vs. No-risk group: > 98). Data were analysed through Kaplan–Meier curves, multivariable Cox regression, restricted cubic spline (RCS) modelling, and subgroup analyses.
Among 1036 completers (13.7% attrition rate), 275 (26.5%) developed MALE during a mean follow-up of 18.9 ± 8.0 months. Kaplan–Meier analysis demonstrated significantly higher MALE incidence in patients in the At-risk group (log-rank p < 0.001). Adjusted Cox models revealed a 45% increased MALE risk in patients in the At-risk group (HR 1.45, 95% CI 1.12–1.86, p = 0.005). RCS identified a non-linear L-shaped relationship (p = 0.006) with inflection at GNRI = 95: Below 95, each 1-unit GNRI increase reduced MALE risk by 9% (HR 0.91, 95% CI 0.88–0.95, p < 0.001), while no significant association existed above 95. Subgroup analyses confirmed consistency across subgroups (all p-interaction > 0.05).
GNRI exhibits a non-linear L-shaped association with MALE risk in elderly patients with PAD, demonstrating critical prognostic utility below the 95 inflection point. Routine GNRI monitoring should be prioritised for patients with GNRI < 95 to guide preventive interventions.
GNRI should be incorporated as a routine risk assessment tool for elderly patients with PAD, with particular vigilance required for those with GNRI < 95. Prioritising nutritional screening and intervention in patients with GNRI < 95 may potentially improve clinical outcomes.
Patients contributed to this study by completing follow-up assessments.
This study followed the STROBE guidelines.
To integrate experiences and perceptions about stroke survivors during the transition from hospital-to-home care.
Seven databases, including PubMed, Embase, Cochrane Library, Ovid, Web of Science, EBSCO and MEDLINE, were searched comprehensively from inception to March 2024, including qualitative studies published in English.
A qualitative systematic review.
The search followed the Preferred Reporting Items report for Systematic Reviews and Meta-analysis (PRISMA 2020). The included research quality was assessed according to the Critical Appraisal Skills Programme (CASP). Meta-aggregation was used to develop analytical themes. Confidence in the Evidence from the Reviews of Qualitative Research (GRADE-CERQual) framework was applied to the findings.
Fifteen qualitative studies were included, from which 54 findings were extracted. Similar findings were summarised into eight categories, resulting in four synthesised findings: Joy and sadness intertwined, Destruction of sense of self and life, External support and internal motivation, and Emotional longings and practical needs.
Stroke can lead to devastating changes in survivors' sense of self and physically. Through external support from family members and healthcare professionals, as well as internal motivation to cope positively, stroke survivors positively accept and adapt to life. Meanwhile they still have high expectations for personal independence and reintegration into society.
The review findings can guide health professionals, survivors and families in optimising care during the hospital-to-home transition.
PROSPERO [CRD42024522555].
ENTREQ.
No Patient or Public Contribution.
As pharmacotherapy often leads to adverse reactions, mind–body exercise (MBE) treatments have become a more popular option for treating depression in people living with breast cancer (BC). However, the most effective type of MBE treatment for this population remains unclear.
The aim of this systematic review and network meta-analysis (NMA) was to compare the efficacy of the different MBE modes for depression in people with BC.
A systematic search for randomized controlled trials (RCTs) from inception to March 25, 2023, was conducted in the following database: EMBASE, PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, China Biology Medicine, OpenGrey, and ClinicalTrials.gov. A traditional meta-analysis was conducted using the random-effects model to directly assess the effectiveness of various MBE interventions. Stata 16.0 software was used for performing the NMA.
The NMA was performed in 32 eligible RCTs including 2361 participants. The efficacy of MBE treatments on depression was ranked as the following: Liuzijue (surface under the cumulative ranking curve [SUCRA] = 95.4%) > Tai chi (SUCRA = 76.9%) > yoga (SUCRA = 55.0%) > Baduanjin (SUCRA = 53.9%) > Pilates (SUCRA = 38.6%) > dance (SUCRA = 30.2%) > Qigong (SUCRA = 28.1%) > control (SUCRA = 21.9%).
Our research showed that Liuzijue and Tai chi might be the most significantly effective MBE intervention for mitigating depression among BC survivors. Healthcare professionals could consider recommending Liuzijue and Tai Chi as a complementary therapy for BC survivors who experience depression.
FreshRSS 