The geriatric nutritional risk index predicts complications after nephrectomy for renal cancer
Int. braz. j. urol
;
49(1): 97-109, Jan.-Feb. 2023. tab, graf
Article
in English
|
LILACS-Express
| LILACS
| ID: biblio-1421713
ABSTRACT
ABSTRACT Purpose:
We examined if malnutrition, as defined by the Geriatric Nutritional Risk Index (GNRI), is independently associated with 30-day postoperative complications in patients undergoing nephrectomy for the treatment of renal cancer. Materials andmethods:
Using the American College of Surgeons National Surgical Quality Improvement Program database from 2006-2019, we identified patients ≥65 years old who underwent nephrectomy for renal cancer. The following formula for GNRI was used to define preoperative nutritional status 1.489 x serum albumin (g/L) + 41.7 x (current body weight [kg]/ ideal body weight [kg]). Based on the GNRI, patients were classified as having no (> 98), moderate (92-98), or severe malnutrition (< 92). After adjusting for potential confounders, multivariable logistic regression analyses were performed to assess the association between GNRI and 30-day postoperative complications. Odds ratios (OR) with 95% confidence intervals (CI) were reported.Results:
A total of 7,683 patients were identified, of which 1,241 (16.2%) and 872 (11.3%) had moderate and severe malnutrition, respectively. Compared to normal nutrition, moderate and severe malnutrition were significantly associated with a greater odds of superficial surgical site infection, progressive renal insufficiency, readmission, extended length of stay, and non-home discharge. Severe malnutrition was also associated with urinary tract infection (OR 2.10, 95% CI 1.31-3.35) and septic shock (OR 2.93, 95% CI 1.21-7.07).Conclusion:
Malnutrition, as defined by a GNRI ≤ 98, is an independent predictor of 30-day complications following nephrectomy. The GNRI could be used to counsel elderly patients with renal cancer prior to nephrectomy.
Full text:
Available
Index:
LILACS (Americas)
Type of study:
Etiology study
/
Prognostic study
/
Risk factors
Language:
English
Journal:
Int. braz. j. urol
Journal subject:
Urology
Year:
2023
Type:
Article
Affiliation country:
United States
Institution/Affiliation country:
University of Florida/US
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