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老年营养风险指数与头颈癌手术后的术后结局

Geriatric Nutritional Risk Index and Postoperative Outcomes Following Head and Neck Cancer Surgery.

作者信息

Kaki Praneet C, Patel Aman M, Brant Jason A, Cannady Steven B, Rajasekaran Karthik, Brody Robert M, Carey Ryan M

机构信息

Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

Rutgers New Jersey Medical School, Newark, New Jersey, USA.

出版信息

Head Neck. 2025 May;47(5):1421-1432. doi: 10.1002/hed.28052. Epub 2024 Dec 30.

Abstract

BACKGROUND

The geriatric nutritional risk index (GNRI) is a tool to assess preoperative nutritional status that can be calculated simply based on height, weight, and serum albumin. This study assesses the utility of GNRI in predicting postoperative complications in patients undergoing major head and neck cancer (HNC) surgery.

METHODS

Retrospective review of the 2016-2020 National Surgical Quality Improvement Program database. Patients were categorized into GNRI > 98 (normal nutritional status), GNRI 92-98 (moderate malnutrition status), and GNRI < 92 (severe malnutrition status). Univariable and multivariable binary logistic regression analyses were performed.

RESULTS

Sixteen thousand seven hundred eight-nine patients undergoing HNC resection were included. On multivariable analysis, moderate and severe malnourishment based on GNRI remained significantly associated with any surgical complication, any medical complication, any complication, Clavien-Dindo grade IV complications, and 30-day mortality.

CONCLUSIONS

GNRI may have utility as a potentially modifiable preoperative prognostic factor that can be optimized to improve complications and mortality following HNC resection.

LEVEL OF EVIDENCE

Level 4.

摘要

背景

老年营养风险指数(GNRI)是一种评估术前营养状况的工具,可根据身高、体重和血清白蛋白简单计算得出。本研究评估GNRI在预测接受头颈癌(HNC)大手术患者术后并发症方面的效用。

方法

回顾性分析2016 - 2020年国家外科质量改进计划数据库。患者被分为GNRI > 98(正常营养状况)、GNRI 92 - 98(中度营养不良状况)和GNRI < 92(严重营养不良状况)。进行单变量和多变量二元逻辑回归分析。

结果

纳入了16789例行HNC切除术的患者。多变量分析显示,基于GNRI的中度和重度营养不良与任何手术并发症、任何医疗并发症、任何并发症、Clavien - Dindo IV级并发症及30天死亡率仍显著相关。

结论

GNRI可能作为一种潜在可改变的术前预后因素,可通过优化该因素来改善HNC切除术后的并发症和死亡率。

证据级别

4级。

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