The correlation between elderly nutritional risk index and anesthesia related adverse reaction in elderly patients undergoing radical resection of colorectal cancer
10.3760/cma.j.cn115455-20240703-00562
- VernacularTitle:老年结直肠癌根治术患者老年营养风险指数与麻醉相关不良反应的相关性研究
- Author:
Yi WANG
1
;
Fei HE
1
;
Juan LI
1
Author Information
1. 绵阳市中心医院麻醉科，绵阳 621000
- Publication Type:Journal Article
- Keywords:
Colorectal neoplasms;
Aged;
Nutritional support;
Geriatric nutritional risk index;
Anesthesia related adverse reactions
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(5):447-451
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the predictive value of the geriatric nutritional risk index (GNRI) for anesthesia related adverse reaction (ARAR) in elderly patients undergoing radical resection of colorectal cancer.Methods:The clinical data of 178 elderly patients undergoing radical resection of colorectal cancer from March 2020 to October 2023 in Mianyang Central Hospital were retrospectively analyzed. Among them, 48 cases had ARAR (ARAR group), and 130 cases did not experience ARAR (control group). The gender, age, body mass index, smoking history, alcoholism history, hypertension, diabetes, hyperlipidemia, tumor location, TNM stage, pathological type, preoperative intestinal obstruction, preoperative chemotherapy, operation mode, operation time, intraoperative bleeding, American Society of Anesthesiologists (ASA) grade, number of lymph node dissection and GNRI were recorded. The prognostic analysis indexes were recorded, including length of hospital stay, unplanned ICU transfer and in-hospital death. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of GNRI for ARAR in elderly patients undergoing radical resection of colorectal cancer. Multifactor Logistic regression analysis was used to analyze the independent risk factors of ARAR in elderly patients undergoing radical resection of colorectal cancer.Results:The age, ASA grade Ⅱ proportion and preoperative chemotherapy proportion in ARAR group were significantly higher than those in control group: (75.35 ± 6.43) years vs. (70.12 ± 5.94) years, 41.67% (20/48) vs. 22.31% (29/130) and 20.83% (10/48) vs. 4.62% (6/130), the GNRI was significantly lower than that in control group: 96.73 ± 6.23 vs. 106.21 ± 6.95, and there were statistical differences ( P<0.01 or <0.05); there were no statistical differences in other indexes between the two groups ( P>0.05). ROC curve analysis result showed that the area under the curve of GNRI for predicting ARAR in elderly patients undergoing radical resection of colorectal cancer was 0.832 (95% CI 0.770 to 0.894, P<0.01), with an optimal cutoff value of 100.5, sensitivity of 70.80%, and specificity of 75.00%. Multifactor Logistic regression analysis result showed that GNRI<98, age ≥80 years, preoperative chemotherapy and ASA grade Ⅱ were independent risk factors for ARAR in elderly patients undergoing radical resection of colorectal cancer ( OR = 2.372, 2.144, 2.708 and 3.280; 95% CI 1.108 to 5.069, 1.072 to 4.382, 1.180 to 6.136 and 1.072 to 9.882; P<0.01 or <0.05). The length of hospital stay and unplanned ICU transfer rate in ARAR group were significantly higher than those in control group: (14.58 ± 3.82) d vs. (11.94 ± 3.66) d and 22.92% (11/48) vs. 10.77% (14/130), and there were statistical differences ( P<0.01 and <0.05); there was no statistical difference in in-hospital mortality between the two groups ( P>0.05). Conclusions:The GNRI is a predictive index of ARAR in elderly patients undergoing radical resection of colorectal cancer. For patients with nutritional risk, preoperative nutritional support should be strengthened to reduce the occurrence of ARAR.
