The Value of Geriatric Nutritional Risk Index in Evaluating Postoperative Complication Risk and Long-Term Prognosis in Elderly Colorectal Cancer Patients

Abstract

Shuangyi Tang,1,* Hailun Xie,2,* Jiaan Kuang,2 Feng Gao,2 Jialiang Gan,2 Hesheng Ou3 1Department of Pharmacy, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, People’s Republic of China; 2Department of Colorectal and Anal Surgery, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, People’s Republic of China; 3Pharmaceutical College, Guangxi Medical University, Nanning, Guangxi, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jialiang GanDepartment of Colorectal and Anal Surgery, The First Affiliated Hospital, Guangxi Medical University, No. 6 Shuangyong Road, Nanning 530021, Guangxi, People’s Republic of ChinaTel [phone]Email [email protected] OuPharmaceutical College of Guangxi Medical University, No. 22 Shuangyong Road, Nanning 530021, Guangxi, People’s Republic of ChinaTel [phone]Email [email protected]: The geriatric nutritional risk index (GNRI) has been reported as a useful tool for predicting the prognosis of many diseases; however, there is currently little research on the relationship between GNRI and outcomes in elderly colorectal cancer (CRC) patients. This study aimed to explore the value of GNRI in evaluating postoperative complication risk and long-term prognosis in elderly CRC patients.Patients and Methods: The medical records of 230 CRC patients aged≥65 years who underwent surgery between January 2012 and December 2014 were retrospectively analyzed. Patients were divided into abnormal and normal GNRI groups by modified binary classification. Logistic regression analysis was used to evaluate the correlation between GNRI and complication risk. The Kaplan–Meier method with log-rank test was used to construct survival curves. The Cox proportional hazard model was used for univariate, multivariate and subgroup survival analyses to assess the relationship between GNRI and long-term prognosis.Results: Multivariate logistic regression analysis showed that GNRI (p = 0.009, HR 2.280, 95% CI: 1.224–4.247) was an independent risk factor for postoperative complications in elderly CRC patients. Kaplan–Meier survival curves revealed that the abnormal GNRI group had significantly lower disease-free survival (DFS; p = 0.005) and overall survival (OS; p=0.007) than the normal GNRI group had, especially in TNM I stage. In multivariate survival analysis, GNRI was an independent prognostic factor for DFS (p = 0.003, HR 1.842, 95% CI: 1.229–2.760) and OS (p = 0.003, HR 1.852, 95% CI: 1.231–2.787).Conclusion: GNRI is a simple and effective tool for predicting the risk of postoperative complications and the long-term prognosis of postoperative elderly CRC patients and can provide a scientific basis for early nutrition interventions in elderly CRC patients.Keywords: colorectal cancer, geriatric nutritional risk index, prognosis, complication  

Keywords

• colorectal cancer
• geriatric nutritional risk index
• prognosis
• complication.