Relationship between Geriatric Nutritional Risk Index and postoperative pulmonary complications in elderly patients undergoing thoracoscopic lung resection
10.3760/cma.j.cn131073.20240326.00908
- VernacularTitle:老年营养风险指数与胸腔镜肺切除术老年患者术后肺部并发症的关系
- Author:
Wei HU
1
;
Weikang SHUI
;
Ya GAO
;
Wenwen MA
;
Shanshan ZHU
Author Information
1. 徐州市肿瘤医院麻醉科，徐州 221005
- Keywords:
Aged;
Pneumonectomy;
Postoperative complications;
Geriatric nutritional risk index
- From:
Chinese Journal of Anesthesiology
2024;44(9):1086-1092
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the relationship between the Geriatric Nutritional Risk Index (GNRI) and postoperative pulmonary complications (PPCs) in elderly patients undergoing thoracoscopic lung resection.Methods:Two hundred and ninety-one elderly patients of either sex, aged ≥60 yr, of American Society of Anesthesiologists Physical Status classificationⅠ-Ⅲ, undergoing elective thoracoscopic lung resection at Xuzhou Cancer Hospital from July 2022 to September 2023, were selected. Patients were divided into high GNRI group or low GNRI group based on the optimal cutoff value of GNRI (represented as a continuous variable) determined by the receiver operating characteristic curve to predict PPCs. The occurrence of PPCs was compared between the two groups within the first 7 postoperative days. The relationship between GNRI and PPCs was evaluated by the logistic regression analysis. The nonlinear correlation between GNRI score (expressed as a continuous variable) and PPCs was investigated by the restricted cubic spline. The accuracy of the GNRI, Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score, and combination of the two in predicting the occurrence of PPCs was evaluated by the areas under the ROC curve (95% confidence interval[ CI]). Results:A total of 269 patients were finally included, with 114 in high GNRI group (GNRI≥100.9) and 155 in low GNRI group (GNRI<100.9). Compared with high GNRI group, the incidence of PPCs was significantly increased compared with low GNRI group (42.6% vs 16.7%, P<0.001). The multivariate logistic regression analysis showed that low GNRI was a risk factor for PPCs, while elevated GNRI score was a protective factor for PPCS in elderly patients undergoing thoracoscopic lung resection ( P<0.05). The restricted cubic spline showed a linear correlation between GNRI score and PPCs ( P=0.947). The areas under the receiver operating characteristic curves of the GNRI, ARISCAT score, and combination of the two in predicting PPCs were 0.646 (95% CI 0.589-0.704), 0.619 (95% CI 0.564-0.674) and 0.708 (95% CI 0.647-0.769), respectively. Conclusions:Low GNRI is an independent risk factor for PPCs in elderly patients undergoing thoracoscopic lung resection, while elevated GNRI score is a protective factor. The combination of GNRI and ARISCAT score can predict the occurrence of PPCs.
