Colback Angela A, Chen Joy, Ershadifar Soroush, Farber Nicole I, Abouyared Marianne
Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, Sacramento, California, USA.
Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
J Nutr Metab. 2025 Sep 15;2025:1073981. doi: 10.1155/jnme/1073981. eCollection 2025.
Malnutrition is associated with increased morbidity and mortality in patients with head and neck cancer (HNC) undergoing surgery. The ability to identify patients who are malnourished with an objective measure is currently a barrier to prompt screening and interventions. Recognizing the need for a screening tool, we used the geriatric nutritional risk index (GNRI) to assess the prevalence of malnutrition and the association between postoperative complications and GNRI scores. A retrospective review of medical records was conducted at a tertiary care academic hospital. A total of 49 HNC patients undergoing surgery with a serum albumin obtained within 6 months of surgery were included in this study. GNRI was calculated as follows: (1.487 × serum albumin [g/L] + (41.7 × current weight/ideal body weight [kg]). Analyses were conducted using univariate statistical methods. 49 patients were included in the study, 32 men (65%) and 17 women (35%), with a mean age of 63 + 12 years. Malnutrition was defined by a GNRI score of < 97.5 and was present in 24% of patients ( = 12). Malnourished patients had significantly higher rates of postoperative complications and discharge to a skilled nursing facility (SNF) compared to controls. A low GNRI score appears to be a predictor of increased complications after head and neck surgery. The GNRI is a simple tool that requires serum albumin, current body weight, and ideal body weight to objectively assess nutrition status. Further studies are needed to assess the utility of using GNRI to assess malnutrition and identify patients who are at high risk for complications during the postoperative course.
营养不良与接受手术的头颈癌(HNC)患者的发病率和死亡率增加有关。目前,使用客观测量方法识别营养不良患者的能力是及时进行筛查和干预的障碍。认识到需要一种筛查工具,我们使用老年营养风险指数(GNRI)来评估营养不良的患病率以及术后并发症与GNRI评分之间的关联。在一家三级医疗学术医院对病历进行了回顾性研究。本研究共纳入49例接受手术且在手术6个月内获得血清白蛋白的HNC患者。GNRI的计算方法如下:(1.487×血清白蛋白[g/L]+(41.7×当前体重/理想体重[kg])。采用单变量统计方法进行分析。49例患者纳入研究,其中男性32例(65%),女性17例(35%),平均年龄63±12岁。GNRI评分<97.5定义为营养不良,24%的患者(n=12)存在营养不良。与对照组相比,营养不良患者术后并发症发生率和转至专业护理机构(SNF)的比例显著更高。低GNRI评分似乎是头颈手术后并发症增加的一个预测指标。GNRI是一种简单的工具,需要血清白蛋白、当前体重和理想体重来客观评估营养状况。需要进一步研究以评估使用GNRI评估营养不良和识别术后过程中并发症高风险患者的效用。