Predictive value of the nutritional risk index for postoperative complications in individuals with pancreatic cancer undergoing pancreaticoduodenectomy

IF 2.4 3区 医学 Q3 GERIATRICS & GERONTOLOGY Geriatric Nursing Pub Date : 2025-01-01 Epub Date: 2025-01-07 DOI:10.1016/j.gerinurse.2024.12.006
Wei Kang Ye MD , Jin Wang MD , Jie Zheng MD , Ming Jiang PD , Yi Nong Zhou PD , Zhi Xiang Wu MD
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Abstract

Purpose

To explore the predictive value of the geriatric nutritional risk index (GNRI) for postoperative complications and their severity in older adults with pancreatic cancer undergoing pancreaticoduodenectomy (PD).

Methods

This study conducted a retrospective analysis of 109 older adults with pancreatic cancer undergoing PD at the Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Quzhou Medical University, between May 2019 and May 2022. Statistical analysis of clinical data was performed to assess the predictive value of the GNRI for postoperative complications and their severity in older adults with pancreatic cancer undergoing PD.

Results

Among the 109 individuals in this study, a total of 41 older adults undergoing PD experienced postoperative complications. The outcomes of the regression analysis showed that preoperative GNRI (OR = 0.184, 95 % CI = 0.023–0.457, P < 0.001), albumin levels (OR = 0.897, 95 % CI = 0.812–0.912, P < 0.001) and haemoglobin levels (OR = 1.231, 95 % CI = 1.043–1.451, P = 0.034) significantly influence the incidence of postoperative complications in older adults with pancreatic cancer. The prognostic value of the GNRI in predicting overall postoperative complications boasts a sensitivity of 83.2 %, specificity of 71.2 %, positive predictive value of 81.1 %, negative predictive value of 65.9 %, accuracy rate of 73.1 %, area under the curve (AUC) of 0.756 (P < 0.001) and a discriminative threshold of 97.0. Furthermore, the predictive efficacy of the GNRI in gauging the severity of postoperative complications demonstrates a sensitivity of 85.32 % and specificity of 79.54 %.

Conclusion

The GNRI can offer a faster, simpler and more effective method for evaluating nutritional risk in individuals with pancreatic tumours. Moreover, for older adults undergoing PD, it can serve as a convenient and efficient nutritional predictive indicator for postoperative complications and their severity.
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营养风险指数对胰腺癌行胰十二指肠切除术患者术后并发症的预测价值
目的:探讨老年营养风险指数(GNRI)对老年胰腺癌行胰十二指肠切除术(PD)术后并发症及其严重程度的预测价值。方法:本研究对2019年5月至2022年5月在衢州医科大学附属医院肝胆胰外科接受PD治疗的109例老年胰腺癌患者进行回顾性分析。对临床资料进行统计分析,评估GNRI对老年胰腺癌行PD术后并发症及其严重程度的预测价值。结果:本研究109例患者中,41例老年PD患者出现术后并发症。回归分析结果显示,术前GNRI (OR = 0.184, 95% CI = 0.023-0.457, P < 0.001)、白蛋白水平(OR = 0.897, 95% CI = 0.812-0.912, P < 0.001)和血红蛋白水平(OR = 1.231, 95% CI = 1.043-1.451, P = 0.034)显著影响老年胰腺癌术后并发症的发生率。GNRI预测术后总并发症的预后价值敏感性为83.2%,特异性为71.2%,阳性预测值为81.1%,阴性预测值为65.9%,准确率为73.1%,曲线下面积(AUC)为0.756 (P < 0.001),判别阈值为97.0。此外,GNRI预测术后并发症严重程度的敏感性为85.32%,特异性为79.54%。结论:GNRI可以提供一种更快、更简单、更有效的评估胰腺肿瘤患者营养风险的方法。此外,对于老年PD患者,它可以作为一种方便、有效的预测术后并发症及其严重程度的营养指标。
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来源期刊
Geriatric Nursing
Geriatric Nursing 医学-护理
CiteScore
3.80
自引率
7.40%
发文量
257
审稿时长
>12 weeks
期刊介绍: Geriatric Nursing is a comprehensive source for clinical information and management advice relating to the care of older adults. The journal''s peer-reviewed articles report the latest developments in the management of acute and chronic disorders and provide practical advice on care of older adults across the long term continuum. Geriatric Nursing addresses current issues related to drugs, advance directives, staff development and management, legal issues, client and caregiver education, infection control, and other topics. The journal is written specifically for nurses and nurse practitioners who work with older adults in any care setting.
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