Association of malnutrition risk evaluated by the geriatric nutritional risk index with post-stroke myocardial injury among older patients with first‑ever ischemic stroke

Abstract Background Post-stroke myocardial injury is a potentially preventable complication after acute ischemic stroke. Therefore, identifying modifiable variables, such as nutritional status, is crucial for reducing the risk of post-stroke myocardial injury. This study aimed to investigate the ass...

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Main Authors: Mu Niu, Faqiang Zhang, Long Wang, Hao Yang, Lina Zhu, Supei Song
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Geriatrics
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Online Access:https://doi.org/10.1186/s12877-025-05796-x
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author Mu Niu
Faqiang Zhang
Long Wang
Hao Yang
Lina Zhu
Supei Song
author_facet Mu Niu
Faqiang Zhang
Long Wang
Hao Yang
Lina Zhu
Supei Song
author_sort Mu Niu
collection DOAJ
description Abstract Background Post-stroke myocardial injury is a potentially preventable complication after acute ischemic stroke. Therefore, identifying modifiable variables, such as nutritional status, is crucial for reducing the risk of post-stroke myocardial injury. This study aimed to investigate the association between malnutrition risk on admission, as evaluated by the Geriatric Nutritional Risk Index (GNRI), and post-stroke myocardial injury in elderly patients with first‑ever ischemic stroke. Methods We conducted this study using the GNRI score to evaluate the nutritional status of older patients with first‑ever ischemic stroke. The primary outcome of interest was post-stroke myocardial injury. Restricted cubic spline (RCS) was executed to assess the dose–effect relationship between the GNRI score and post-stroke myocardial injury. The correlation of malnutrition risk identified by GNRI score for post-stroke myocardial injury was examined using multivariate logistic regression analysis. To balance the potential confounders and verify the robustness of the results, propensity score matching (PSM) was further conducted. Results Based on the GNRI score, 30.8% of patients were at moderate to severe risk of malnutrition. The overall incidence of post-stroke myocardial injury was 33.2%. The adjusted RCS analysis revealed a negative dose–response relationship between the GNRI score and post-stroke myocardial injury (P for non-linearity = 0.536). After adjusting for confounders, moderate to severe malnutrition risk, as evaluated by the GNRI score, was substantially associated with an increased risk of post-stroke myocardial injury (OR: 3.25; 95% CI: 1.93–5.48; P < 0.001). Following PSM adjustment, the association between the GNRI score and post-stroke myocardial injury remained significantly robust (OR: 4.28; 95% CI: 2.34–7.83; P < 0.001). Conclusion Malnutrition risk on admission is associated with higher risk of post-stroke myocardial injury among elderly patients with first‑ever ischemic stroke. Early screening for malnutrition risk is crucial in the management of patients with first‑ever ischemic stroke.
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spelling doaj-art-6abbddd3eab645ca85e9ed4af98e0eed2025-08-20T03:03:46ZengBMCBMC Geriatrics1471-23182025-03-0125111210.1186/s12877-025-05796-xAssociation of malnutrition risk evaluated by the geriatric nutritional risk index with post-stroke myocardial injury among older patients with first‑ever ischemic strokeMu Niu0Faqiang Zhang1Long Wang2Hao Yang3Lina Zhu4Supei Song5Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical UniversityDepartment of Anesthesiology, Shanghai Pulmonary Hospital, Tongji University School of MedicineDepartment of Pain Medicine, The First Medical Center, Chinese PLA General HospitalDepartment of Anesthesiology, Shanghai Pulmonary Hospital, Tongji University School of MedicineDepartment of Ophthalmology, Renji Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Critical Care Medicine, Xuzhou Hospital of Traditional Chinese Medicine, Xuzhou Hospital Affiliated to Nanjing University of Chinese MedicineAbstract Background Post-stroke myocardial injury is a potentially preventable complication after acute ischemic stroke. Therefore, identifying modifiable variables, such as nutritional status, is crucial for reducing the risk of post-stroke myocardial injury. This study aimed to investigate the association between malnutrition risk on admission, as evaluated by the Geriatric Nutritional Risk Index (GNRI), and post-stroke myocardial injury in elderly patients with first‑ever ischemic stroke. Methods We conducted this study using the GNRI score to evaluate the nutritional status of older patients with first‑ever ischemic stroke. The primary outcome of interest was post-stroke myocardial injury. Restricted cubic spline (RCS) was executed to assess the dose–effect relationship between the GNRI score and post-stroke myocardial injury. The correlation of malnutrition risk identified by GNRI score for post-stroke myocardial injury was examined using multivariate logistic regression analysis. To balance the potential confounders and verify the robustness of the results, propensity score matching (PSM) was further conducted. Results Based on the GNRI score, 30.8% of patients were at moderate to severe risk of malnutrition. The overall incidence of post-stroke myocardial injury was 33.2%. The adjusted RCS analysis revealed a negative dose–response relationship between the GNRI score and post-stroke myocardial injury (P for non-linearity = 0.536). After adjusting for confounders, moderate to severe malnutrition risk, as evaluated by the GNRI score, was substantially associated with an increased risk of post-stroke myocardial injury (OR: 3.25; 95% CI: 1.93–5.48; P < 0.001). Following PSM adjustment, the association between the GNRI score and post-stroke myocardial injury remained significantly robust (OR: 4.28; 95% CI: 2.34–7.83; P < 0.001). Conclusion Malnutrition risk on admission is associated with higher risk of post-stroke myocardial injury among elderly patients with first‑ever ischemic stroke. Early screening for malnutrition risk is crucial in the management of patients with first‑ever ischemic stroke.https://doi.org/10.1186/s12877-025-05796-xGeriatric nutritional risk index (GNRI)Nutritional statusMalnutrition screening toolsPost-stroke myocardial injuryFirst‑ever ischemic stroke
spellingShingle Mu Niu
Faqiang Zhang
Long Wang
Hao Yang
Lina Zhu
Supei Song
Association of malnutrition risk evaluated by the geriatric nutritional risk index with post-stroke myocardial injury among older patients with first‑ever ischemic stroke
BMC Geriatrics
Geriatric nutritional risk index (GNRI)
Nutritional status
Malnutrition screening tools
Post-stroke myocardial injury
First‑ever ischemic stroke
title Association of malnutrition risk evaluated by the geriatric nutritional risk index with post-stroke myocardial injury among older patients with first‑ever ischemic stroke
title_full Association of malnutrition risk evaluated by the geriatric nutritional risk index with post-stroke myocardial injury among older patients with first‑ever ischemic stroke
title_fullStr Association of malnutrition risk evaluated by the geriatric nutritional risk index with post-stroke myocardial injury among older patients with first‑ever ischemic stroke
title_full_unstemmed Association of malnutrition risk evaluated by the geriatric nutritional risk index with post-stroke myocardial injury among older patients with first‑ever ischemic stroke
title_short Association of malnutrition risk evaluated by the geriatric nutritional risk index with post-stroke myocardial injury among older patients with first‑ever ischemic stroke
title_sort association of malnutrition risk evaluated by the geriatric nutritional risk index with post stroke myocardial injury among older patients with first ever ischemic stroke
topic Geriatric nutritional risk index (GNRI)
Nutritional status
Malnutrition screening tools
Post-stroke myocardial injury
First‑ever ischemic stroke
url https://doi.org/10.1186/s12877-025-05796-x
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