BACKGROUND A rotator cuff retear following arthroscopic rotator cuff repair (ARCR) is a concern in older patients. However, only a few of its risk factors are amenable to preoperative intervention. We aimed to elucidate the relationship between preoperative nutritional status and rotator cuff retears after ARCR. METHODS This single-center retrospective study included patients aged ≥65 years with rotator cuff tears who underwent ARCR. The Geriatric Nutritional Risk Index (GNRI) was used to assess preoperative nutritional status. Data collection encompassed patient demographics, clinical assessments, and surgical specifics. Patients were divided into healed and retear groups based on 2-year post-ARCR magnetic resonance imaging results. Logistic regression analysis was conducted to adjust for confounding factors and detect independent risk factors for retears. The GNRI cutoff value for retear prediction was determined by a stratum-specific likelihood ratio; clinical outcomes were compared based on the cutoff values obtained. RESULTS Overall, 143 patients were included. The retear rate was 20.3%. The albumin level, GNRI, postoperative shoulder strength of abduction and external rotation, and postoperative Japanese Orthopaedic Association and Constant scores in the retear group were significantly lower than those in the healed group. The logistic regression analysis showed that low risk of morbidity and mortality (compared with no risk) based on the GNRI (odds ratio [OR], 3.39) and medial-lateral tear size per mm (OR = 1.10) were independent risk factors for a retear 2 years after ARCR. Stratum-specific likelihood ratio analysis identified data-driven strata as GNRI < 103, 103 ≤ GNRI < 109, and GNRI ≥ 109. Univariate analysis showed that patients with GNRI < 103 had a significantly higher retear risk than those with 103 ≤ GNRI < 109 and those with GNRI ≥ 109. Logistic regression analysis showed that GNRI < 103 compared with 103 ≤ GNRI < 109 (OR = 3.88) and GNRI < 103 compared with GNRI ≥ 109 (OR = 5.62), along with the medial-lateral tear size per mm (OR = 1.10), were independent risk factors for a retear at 2 years after ARCR. CONCLUSIONS When assessing the risk of a retear after ARCR, GNRI ≥ 103 may indicate good preoperative nutritional status. However, more data are essential to ascertain the importance of this finding. LEVEL OF EVIDENCE Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

中文翻译：

---

术前营养会影响关节镜下肩袖修复术后的视网膜恢复率。


背景技术关节镜下肩袖修复（ARCR）后的肩袖再撕裂是老年患者所关心的问题。然而，只有少数危险因素适合术前干预。我们的目的是阐明术前营养状况与 ARCR 后肩袖撕裂之间的关系。方法 这项单中心回顾性研究纳入了年龄≥65 岁且接受 ARCR 的肩袖撕裂患者。老年营养风险指数（GNRI）用于评估术前营养状况。数据收集包括患者人口统计、临床评估和手术细节。根据 2 年 ARCR 磁共振成像结果，将患者分为治愈组和复发组。进行逻辑回归分析以调整混杂因素并检测退学的独立危险因素。后退预测的 GNRI 截止值由特定层的似然比确定；根据获得的截止值比较临床结果。结果 总体而言，纳入了 143 名患者。延迟率为20.3%。复位组白蛋白水平、GNRI、术后肩外展、外旋力量、术后日本骨科协会评分及Constant评分均显着低于愈合组。逻辑回归分析显示，基于 GNRI（优势比 [OR]，3.39）和每毫米内侧-外侧撕裂尺寸（OR = 1.10）的低发病率和死亡率风险（与无风险相比）是独立危险因素。 ARCR 后 2 年后复读。特定层似然比分析将数据驱动层确定为 GNRI < 103、103 ≤ GNRI < 109 和 GNRI ≥ 109。 单变量分析显示，GNRI < 103 患者的再眼动风险显着高于 103 ≤ GNRI < 109 和 GNRI ≥ 109 患者。Logistic 回归分析显示，GNRI < 103 与 103 ≤ GNRI < 109 患者相比（ OR = 3.88) 和 GNRI < 103 与 GNRI ≥ 109 (OR = 5.62) 相比，以及每毫米内侧-外侧撕裂尺寸 (OR = 1.10)，是 ARCR 后 2 年再发生的独立危险因素。结论 在评估 ARCR 术后再术后风险时，GNRI ≥ 103 可能表明术前营养状况良好。然而，需要更多数据来确定这一发现的重要性。证据级别 预后 III 级。有关证据级别的完整描述，请参阅作者须知。