Yamana Ippei, Takeno Shinsuke, Shibata Ryosuke, Shiwaku Hironari, Maki Kenji, Hashimoto Tatsuya, Shiraishi Takeshi, Iwasaki Akinori, Yamashita Yuichi
Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
Eur Surg Res. 2015;55(1-2):35-42. doi: 10.1159/000376610. Epub 2015 Mar 17.
The Geriatric Nutritional Risk Index (GNRI) is a new index recently introduced for predicting the risk of nutrition-related complications. The GNRI has mainly been reported as a simple and accurate tool to assess the nutritional status and prognosis of elderly patients. So far, there have been no reports of the GNRI in patients with gastrointestinal cancer. Our objective was to examine the association between the GNRI and short-term outcomes, especially postoperative complications, in patients with esophageal cancer who underwent esophagectomy and gastric tube reconstruction.
The present study enrolled 122 consecutive patients with esophageal cancer who underwent esophagectomy and gastric tube reconstruction. The GNRI at admission to the hospital was calculated as follows: (1.489 × albumin in g/l) + (41.7 × present/ideal body weight). The characteristics and short-term outcomes were compared between two groups: the high (GNRI ≥90) and the low (GNRI <90) GNRI group. The mortality and morbidity rates, especially the rates regarding respiratory complications and anastomotic leakage, were investigated.
The mean age of the 122 patients was 63.9 ± 9.1 years (range 43-83). There were no significant differences in either patient or operative characteristics. The low GNRI group had a significantly higher rate of respiratory complications (p = 0.002). A multivariate analysis demonstrated that the GNRI was the only independent significant factor predicting respiratory complications (hazard ratio 3.41, 95% confidence interval 1.19-9.76; p = 0.022).
The GNRI is considered to be a clinically useful marker that can be used to assess the nutritional status and predict the development of postoperative respiratory complications in patients with esophageal cancer undergoing esophagectomy and gastric tube reconstruction.
老年营养风险指数（GNRI）是最近推出的用于预测营养相关并发症风险的新指数。GNRI主要被报道为评估老年患者营养状况和预后的一种简单且准确的工具。迄今为止，尚无关于胃肠道癌症患者GNRI的报道。我们的目的是研究在接受食管切除术和胃管重建的食管癌患者中，GNRI与短期结局尤其是术后并发症之间的关联。
本研究纳入了122例连续接受食管切除术和胃管重建的食管癌患者。入院时的GNRI计算如下：（1.489×白蛋白浓度（g/l））+（41.7×实际体重/理想体重）。比较了高GNRI组（GNRI≥90）和低GNRI组（GNRI<90）两组的特征和短期结局。调查了死亡率和发病率，尤其是呼吸并发症和吻合口漏的发生率。
122例患者的平均年龄为63.9±9.1岁（范围43 - 83岁）。患者或手术特征方面均无显著差异。低GNRI组的呼吸并发症发生率显著更高（p = 0.002）。多因素分析表明，GNRI是预测呼吸并发症的唯一独立显著因素（风险比3.41，95%置信区间1.19 - 9.76；p = 0.022）。
GNRI被认为是一种临床上有用的标志物，可用于评估接受食管切除术和胃管重建的食管癌患者的营养状况，并预测术后呼吸并发症的发生。
