The Geriatric Nutritional Risk Index Predicts Postoperative Outcomes in Bladder Cancer: A Propensity Score-Matched Analysis

Riveros, Carlos; Jazayeri, Seyed Behzad; Chalfant, Victor; Ahmed, Ferdous; Bandyk, Mark; Balaji, K C

doi:10.1097/ju.0000000000002342

Cited by 24 publications

(21 citation statements)

References 27 publications

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“…The AAPR and NRI are also based on albumin, which has been verified as a prognostic factor for many cancers. 21,[38][39][40][41] In our study, low NRI and low AAPR were significantly related to poor OS. Moreover, as observed in previous studies, performance status, LDH, and age were significantly related to survival outcomes in our patients with MM.…”

Section: Discussionsupporting

confidence: 53%

Inflammatory and Nutritional Scoring System for Predicting Prognosis in Patients with Newly Diagnosed Multiple Myeloma

Zhang

Chen

Wang

et al. 2023

JIR

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We aimed to assess the prognostic value of pretreatment inflammatory and nutritional parameters for predicting overall survival (OS) in patients with newly diagnosed multiple myeloma (NDMM), and to build a new scoring system using the most important variables. Methods: We retrospectively analyzed baseline clinical and laboratory data for patients with NDMM, who were randomly grouped into training and validation cohorts at a ratio of 8:2. The Inflammatory Nutritional Score (INS) was developed based on the least absolute shrinkage and selection operator (LASSO) Cox regression. The INS and other independent prognostic factors were entered into a multivariate Cox model and merged to generate a nomogram model for predictive optimization. Performance and predictive accuracy were assessed using the concordance index (C-index), calibration plots, and time-dependent receiver operating characteristic (ROC) curves. Results: In total, 442 eligible patients were enrolled. Six inflammatory/nutritional variables, including the Nutritional Risk Index (NRI), body mass index (BMI), neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), and albumin-alkaline phosphatase ratio (AAPR), were integrated to construct the INS using the LASSO Cox model. The predictive nomogram constructed following the multivariate Cox analysis included INS, performance status, lactate dehydrogenase, age, and C-reactive protein. The model exhibited good predictive performance, with a C-index of 0.708 in the training cohort and 0.749 in the validation cohort. Moreover, the calibration curves also demonstrated excellent consistency between predicted and observed survival in both cohorts. In the time-dependent ROC analysis, our nomogram model exhibited better performance than other staging systems for multiple myeloma. Conclusion:The INS represents an independent prognostic signature in patients with NDMM. Our novel nomogram based on INS may aid in predicting survival probability and stratifying risk.

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Section: Discussionsupporting

confidence: 53%

Inflammatory and Nutritional Scoring System for Predicting Prognosis in Patients with Newly Diagnosed Multiple Myeloma

Zhang

Chen

Wang

et al. 2023

JIR

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“…Riveros et al . found that in bladder cancer patients receiving radical cystectomy, GNRI independently predicts mortality, blood transfusion, pneumonia, extended length of stay and non-home discharge 16 . Additional to survival and perioperative complications outcome, they also suggest that low GNRI was associated with extended length of hospital stay and nonhome discharge.…”

Section: Discussionmentioning

confidence: 95%

“…In a large-scale retrospective study, Kang et al found that low values of GNRI are associated with aggressive pathologic characteristics and poor survival in patients with renal clear cell carcinoma who have nephrectomy 17 . Riveros et al found that in bladder cancer patients receiving radical cystectomy, GNRI independently predicts mortality, blood transfusion, pneumonia, extended length of stay and non-home discharge 16 . Additional to survival and perioperative complications outcome, they also suggest that low GNRI was associated with extended length of hospital stay and nonhome discharge.…”

Section: Discussionmentioning

confidence: 99%

Geriatric nutritional risk index as a prognostic marker for patients with upper tract urothelial carcinoma receiving radical nephroureterectomy

Chang

Hung

Chen

et al. 2023

Sci Rep

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To investigate the prognostic value of the geriatric nutritional risk index (GNRI) in patients with upper tract urothelial cell carcinoma (UTUC) receiving radical nephroureterectomy (RNU). Between January 2001 and December 2015, we enrolled 488 patients with UTUC underwent RNU in Taichung Veterans General Hospital. GNRI before radical surgery was calculated based on serum albumin level and body mass index. The malnutritional status was defined as GNRI < 92.0. Using Kaplan–Meier analyses and Cox proportional hazards models to analyze the risk factors on disease-free survival (DFS), cancer-specific survival (CSS) and overall survival (OS). 386 patients were categorized as normal nutritional status (GNRI ≥ 92) and 102 patients as malnutritional status (GNRI < 92). We used the receiver operating characteristic (ROC) curve for determined the association between GNRI and OS, with area under the curve (AUC) being 0.69. The 5-year survival rate of DFS, CSS and OS were 48.6%, 80.5% and 80.5% in the normal nutritional group and 28.0%, 53.2% and 40% in the malnutritional group. Using the multivariate analysis, malnutritional status was found as an independent risk factor for OS (hazard ratio [HR] = 3.94, 95% confidence interval [CI] 2.70–5.74), together with age (HR = 1.04, 95% CI 1.02–1.06), surgical margin positive (HR = 1.78, 95% CI 1.13–2.82), pathological T3 (HR = 2.54, 95% CI 1.53–4.21), pathological T4 (HR = 6.75, 95% CI 3.17–14.37) and lymphovascular invasion (HR = 1.81, 95% CI 1.16–2.81). We also found GNRI index as independent risk factor in DFS (HR = 1.90, 95% CI 1.42–2.54) and CSS (HR = 5.42, 95% CI 3.24–9.06). Preoperative malnutritional status with low GNRI is an independent marker in predicting DFS, CSS and OS in UTUC patients underwent RNU.

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“…PEM has been associated with a number of health outcomes, disease states, and illnesses [16,17]. The Geriatric Nutritional Risk Index (GNRI) is a simple screening tool to investigate nutrition-related dose-response association with morbidity and mortality of diseases [18][19][20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

The protein-energy malnutrition is associated with the prevalence and mortality of periodontitis: a dose-response association study

Zhang

Liu²,

et al. 2023

Preprint

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Objective: This study aimed to explore the association between protein-energy malnutrition (PEM) and the prevalence and mortality rate of geriatric periodontitis. Materials and Methods: Participants were recruited from the National Health and Nutrition Examination Surveys (NHANES) between the 1999-2004 and 2009-2014 cycles. Geriatric nutritional risk index (GNRI) as the measurement of PEM and periodontitis was defined according to periodontal examination. Periodontal examination and GNRI data were collected for participants aged ≥65 years. Multifactorial logistic regression was performed to assess the association between GNRI and periodontitis. Cox regression was used to assess the association between GNRI and mortality in patients with periodontitis. Restricted cubic spline (RCS) was used to explore the dose-response association. Results: Overall, 4442 participants were enrolled. Logistic regression showed that GNRI was significantly associated with periodontitis (OR, 0.981; 95%CI, 0.967–0.995, P=0.009), and RCS showed a significantly increased risk of periodontitis when GNRI was <114.99. Cox regression analysis indicated that GNRI was associated with mortality in patients with periodontitis (HR, 0.979; 95%CI, 0.971–0.986, P<0.001), and RCS showed a significantly increased risk of mortality when GNRI was <114.28. Conclusion: This study found a significant association between PEM and the risk of periodontitis and periodontitis patients’mortality, and this association was more pronounced among those aged 80 years and older. Clinical Relevance: PEM is associated with periodontitis and may increase the risk of periodontitis participants’ mortality. More attention demanded to the nutritional intake of protein and energy in geriatric populations, especially those with periodontitis.

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The Geriatric Nutritional Risk Index Predicts Postoperative Outcomes in Bladder Cancer: A Propensity Score-Matched Analysis

Cited by 24 publications

References 27 publications

Inflammatory and Nutritional Scoring System for Predicting Prognosis in Patients with Newly Diagnosed Multiple Myeloma

Inflammatory and Nutritional Scoring System for Predicting Prognosis in Patients with Newly Diagnosed Multiple Myeloma

Geriatric nutritional risk index as a prognostic marker for patients with upper tract urothelial carcinoma receiving radical nephroureterectomy

The protein-energy malnutrition is associated with the prevalence and mortality of periodontitis: a dose-response association study

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