J Clin Nutr.  2014 Apr;6(1):30-36. 10.15747/jcn.2014.6.1.30.

Validation of Geriatric Nutritional Risk Index and Percent Weight Loss as a Predictor of Post-operative Complications after Gastrectomy in Elderly Patients

• Lee KE
• Son YG
• Ryu SW

• KMID: 2287735
• DOI: http://doi.org/10.15747/jcn.2014.6.1.30

Abstract

PURPOSE
Gastric cancer surgery is expected to increase in frequency in elderly patients aged over 65 years. The aim of this study was to validate the Geriatric Nutritional Risk Index (GNRI) and percent weight loss as a predictor of post-operative complications after gastrectomy in elderly patients.
METHODS
We retrospectively collected data on elderly patients (over 65 years) who underwent gastrectomy for gastric cancer at Keimyung University Dongsan Medical Center between January 2010 and December 2012. Data included patientsocharacteristics (body mass index [BMI], underlying disease, body weight loss during 3 months before gastrectomy, American Society of Anesthesiologists [ASA] score, and stage of disease), operative characteristics (operation method, operation time, and blood loss during operation), GNRI, and post-operative complications after gastrectomy.
RESULTS
A total of 321 patients were included. The patients'mean age was 72.4+/-4.7 years, and 49.5% of patients were rated as being at risk by the GNRI. There were no differences in post-operative complications by GNRI, age, sex, ASA score, BMI, serum albumin, co-morbidity, stage of disease, surgical approach, type of surgery, extent of lymph node dissection, operation time, or blood loss during surgery. However, percent weight loss during 3 months was correlated independently with post-operative complications (P<0.001). In logistic regression analysis, a 1% increase in percent weight loss was associated with a 1.102 times increase in the incidence of postoperative complications (P=0.012, 95% confidence interval 1.021~1.189).
CONCLUSION
The percent weight loss during 3 months before gastrectomy could help predict post-operative complications in elderly patients.

Keyword

Gastrectomy; Postoperative complications; Malnutrition

MeSH Terms

Aged*
Body Weight
Gastrectomy*
Humans
Incidence
Logistic Models
Lymph Node Excision
Malnutrition
Postoperative Complications
Retrospective Studies
Serum Albumin
Stomach Neoplasms
Weight Loss*
Serum Albumin