Geriatric nutritional risk index predicts surgical site infection after pancreaticoduodenectomy

Funamizu, Naotake; Nakabayashi, Yukio; Iida, Takuya; Kurihara, Kazunao

doi:10.3892/mco.2018.1671

Cited by 20 publications

(24 citation statements)

References 28 publications

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“…The GNRI based on the two variables was developed to evaluate malnutrition and related morbidity and mortality in hospitalized elderly patients [6]. The GNRI has been reported to be a useful tool to predict surgical site infection after pancreaticoduodenectomy [15], nutritional status and clinical outcomes in peritoneal dialysis patients [16], and clinical outcomes in patients with pyogenic liver abscess [17]. On the other hand, the CONUT based on the three variables was developed to detect malnutrition and assess nutritional status in hospitalized patients [7].…”

Section: Discussionmentioning

confidence: 99%

Geriatric Nutritional Risk Index and Controlling Nutritional Status Score can predict postoperative 180-day mortality in hip fracture surgeries

Kotera

2019

JA Clin Rep

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Background: The Geriatric Nutritional Risk Index (GNRI) based on serum albumin level and body weight and the Controlling Nutritional Status Score (CONUT) based on serum albumin level, total cholesterol level, and total lymphocyte count were created to evaluate objectively a patient's nutritional status in 2005. Here we validated the usefulness of the GNRI and the CONUT as a prognostic factor of the 180-day mortality in patients who underwent hip fracture surgeries. We retrospectively collected data from patients with hip surgeries performed from January 2012 to December 2018. The variables required for the GNRI and the CONUT and the factors presumably associated with postoperative mortality including the patients' characteristics were collected from the medical charts. Intergroup differences were assessed with the χ 2 test with Yates' correlation for continuity in category variables. The Mann-Whitney U test was used to test for differences in continuous variables. We validated the power of the GNRI and the CONUT values to distinguish patients who died ≤ 180 days post-surgery from those who did not, by calculating the area under the receiver operating characteristic curve (AUC). The correlation between these two models was analyzed by Spearman's rank correlation (ρ). Results: We retrospectively examined the cases of 607 patients aged 87 ± 6 (range 70-102) years old. The 180-day mortality rate was 5.4% (n = 33 non-survivors). The GNRI value in the non-survivors was 83 ± 9 (range 66-111), which was significantly lower than that in the survivors at 92 ± 9 (range 64-120). The CONUT value in the nonsurvivors was 6 ± 3 (range 1-11), which was significantly higher than that in the survivors at 4 ± 2 (range 0-11). The AUC value to predict the 180-day mortality was 0.74 for the GNRI and 0.72 for the CONUT. The ρ value between these two models was 0.61 in the total of 607 patients and was 0.78 in the 33 non-survivors. Conclusions: Our results suggest that the GNRI and the CONUT are a simple and useful tool to predict the 180day mortality in patients who have undergone a hip surgery.

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Section: Discussionmentioning

confidence: 99%

Geriatric Nutritional Risk Index and Controlling Nutritional Status Score can predict postoperative 180-day mortality in hip fracture surgeries

Kotera

2019

JA Clin Rep

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“…related morbidity and mortality in elderly patients (6). Our previous study showed that a low GNRI was associated with wound infections and POPF in patients who undergo PD (15). Therefore, we hypothesized that GNRI could be predictive of POPF following DP.…”

Section: Discussionmentioning

confidence: 93%

Lower geriatric nutritional risk index predicts postoperative pancreatic fistula in patients with distal pancreatectomy

2019

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Postoperative pancreatic fistula (POPF) is a common complication following pancreatic resection. It leads to increased medical costs, and longer hospital stays. However, the risk factors of POPF are still unclear, and therefore, this urgent clinical issue should be resolved. The geriatric nutritional risk index (GNRI) is tool to assess the nutritional status using body weight, and serum albumin value, particularly in elderly patients. On the other hand, POPF is associated with body mass index (BMI). Thus, the present study aimed to investigate whether GNRI can predict the risk of POPF in patients after distal pancreatectomy (DP). We conducted a retrospective cohort study involving 37 patients who were treated at the Department of Digestive Surgery, Kawaguchi Municipal Medical Center between January 2007 and June 2018. All patients were subjected to nutritional screening using GNRI, and were followed up after DP for postoperative complications including POPF. In addition, risk factors of POPF, and patient's height, BMI, and preoperative laboratory values were analyzed. POPF was observed in 7 of the 37 (19%) patients. Those with a POPF had significantly lower GNRI values than those without POPF (P<0.001). Receiver operating characteristic curve analysis was performed to determine a cutoff value of GNRI, which indicated an increased risk of POPF. This value was determined as 96 (sensitivity: 71.4%, specificity: 86.7%, likelihood ratio: 5.36). Univariate analysis confirmed that a GNRI of <96 was significantly associated with POPF (P= 0.005), and a multivariate logistic regression analysis revealed that a GNRI of <96 was significant independent predictor of POPF (P= 0.005), suggesting its utility for assessing the risk of POPF following DP.

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“…Among them, we focused on GNRI, which includes albumin and BMI, primarily because of availability of the required parameters and lack of invasiveness. Until now, it had been reported that lower GNRI was associated with increased risk of surgical site infections in patients following PD [ 11 ], and POPF in patients with distal pancreatectomy at a different hospital [ 22 ]. In detail, a lower GNRI value was strongly associated with a higher risk of surgical site infections, supporting the use of nutritional assessment prior to an elective surgical procedure.…”

Section: Discussionmentioning

confidence: 99%

“…For instance, Wang et al showed that GNRI could be used to risk stratify elderly patients who underwent radiotherapy or definitive concurrent chemoradiotherapy [ 27 ]. In addition, our previous report revealed that GNRI has been identified as a risk factor for SSIs in patients after PD [ 11 ]. Moreover, Kushiyama et al showed that GNRI is useful marker in predicting postoperative complications for elderly patients after gastrectomy [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

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Geriatric Nutritional Risk Index Less Than 92 Is a Predictor for Late Postpancreatectomy Hemorrhage Following Pancreatoduodenectomy: A Retrospective Cohort Study

Funamizu

Omura

Takada

et al. 2020

Cancers

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Postpancreatectomy hemorrhage (PPH) is the most lethal complication of pancreatoduodenectomy (PD). The main risk factor for PPH is the development of a postoperative pancreatic fistula (POPF). Recent evidence shows that the geriatric nutritional risk index (GNRI) may be predictive indicator for POPF. In this study, we aimed to evaluate whether GNRI is a reliable predictive marker for PPH following PD. The present study retrospectively evaluated 121 patients treated with PD at Ageo Central General Hospital in Japan between January 2015 and March 2020. We investigated the potential of age, gender, body mass index, serum albumin, American Society of Anesthesiologists classification (ASA), diabetes mellitus and smoking status, time taken for the operation, estimated blood loss, and postoperative complications (POPF, bile leak, and surgical site infections) to predict the risk of PPH following PD using univariate and multivariate analyses. Ten patients had developed PPH with an incidence of 8.3%. Among them, the patients were divided into bleeding group (n = 10) and non-bleeding group (n = 111). The bleeding group had significantly lower GNRI values than those in the non-bleeding group (p = 0.001). We determined that the cut-off value of GNRI was 92 accounting for a sensitivity 80.0%, specificity 82.9%, and likelihood ratio of 4.6 using receiver operating characteristic curve analysis. A GNRI of <92 was statistically associated with PPH in both univariate (p < 0.001) and multivariate analysis (p = 0.01). Therefore, we could identify that a GNRI < 92 was an independently potential predictor of PPH risk following PD. We should alert surgeons if patients have low level GNRI before PD.

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Geriatric nutritional risk index predicts surgical site infection after pancreaticoduodenectomy

Cited by 20 publications

References 28 publications

Geriatric Nutritional Risk Index and Controlling Nutritional Status Score can predict postoperative 180-day mortality in hip fracture surgeries

Geriatric Nutritional Risk Index and Controlling Nutritional Status Score can predict postoperative 180-day mortality in hip fracture surgeries

Lower geriatric nutritional risk index predicts postoperative pancreatic fistula in patients with distal pancreatectomy

Geriatric Nutritional Risk Index Less Than 92 Is a Predictor for Late Postpancreatectomy Hemorrhage Following Pancreatoduodenectomy: A Retrospective Cohort Study

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