A web‐based calculator combining Geriatric Nutritional Risk Index (GNRI) and Tilburg Frailty Indicator (TFI) predicts postoperative complications among young elderly patients with gastric cancer

Abstract

Nutritional status and frailty are significant indicators reflecting physiological reserve. We sought to establish and validate a web-based calculator containing the Geriatric Nutritional Risk Index (GNRI) and the Tilburg Frailty Indicator (TFI) together with general clinical information to predict total complications among elderly patients with gastric cancer.Methods: This was a prospective cohort study of 582 elderly patients with gastric cancer in a tertiary hospital in China. Nutritional status and frailty were assessed by the GNRI and the TFI, respectively. The nomogram was built and further converted into a web-based calculator. The receiver operating characteristic analysis was performed to evaluate the discrimination of the nomogram. Calibration was assessed using the calibration curve and Hosmer-Lemeshow test via the bootstrap resampling procedure. The decision curve analyses (DCAs) were employed to quantify the net benefits of a certain threshold probability for assessing the clinical values. Results:The GNRI (odds ratio [OR], 0.921; 95% confidence interval [CI], 0.895-0.949; P < 0.001), the TFI (OR, 1.243; 95% CI, 1.113-1.386; P < 0.001), surgical approach (OR, 1.913; 95% CI, 1.073-3.408; P = 0.028) and comorbidity (OR = 1.599, 95% CI = 1.028-2.486, P = 0.037) were independently associated with total complications. The nomogram demonstrated good discrimination (area under the receiver operating characteristic curve: training cohort, 0.735; validation cohort, 0.777) and calibration (P = 0.135). The DCA curves of the nomogram also showed good positive net benefits. Conclusions:The web-based calculator incorporating the GNRI, the TFI, surgical approach, and comorbidity could successfully predict total complications among elderly patients with gastric cancer with good accuracy in a convenient manner.

Comparison of three frailty scales for prediction of prolonged postoperative ileus following major abdominal surgery in elderly patients: a prospective cohort study

“…On the other hand, our findings also highlight the requirement for further studies that include comparisons between variable frailty measurements (e.g. G8 questionnaire [ 54 ], Frailty Index [ 55 ], Tilburg Frailty Indicator [ 56 ], which are widely used and validated in oncological patients or surgical patients [ 57 – 60 ]), and for the research to consider effect sizes, prediction accuracy, and pragmatic considerations like feasibility, importance and efficiency.…”

Inflammatory status predicts prognosis in patients with gastric cancer with early pyloric stenosis who underwent radical resection: A propensity score‑matching analysis

“…Nutritional status has been demonstrated to be related to the prognosis of various cancers (20)(21)(22)(23). A study conducted by Sun et al (24) on the Prognostic Nutritional Index (PNI) in gastric cancer confirmed the association between poor nutritional status and poor survival outcomes.…”

Frailty is a Risk Factor for Postoperative Complications in Older Adults with Lumbar Degenerative Disease: A Prospective Cohort Study

“…It is worth noting that studies have confirmed that mFI-11 can predict postoperative complications in patients undergoing spinal surgery, 38 , 39 but there is no relevant study on the relationship between frailty based on TFI and postoperative complications of spinal surgery. However, liu et al 40 have identified that frailty based on TFI emerged as a significant predictor of the post-operative quality of recovery and complications in patients with gynecologic cancer; Miao et al 41 have demonstrated the successful prediction of total complications among older adults with gastric cancer through the combined use of TFI with other factors, emphasizing the potential of TFI as a promising tool for frailty assessment and risk stratification in surgical populations. The trauma induced by lumbar surgery and anesthesia can incite diverse stress-related changes in the body.…”