Geriatric Nutritional Risk Index Predicts Postoperative Complications in Elderly Patients Undergoing Robot-Assisted Radical Cystectomy.

OBJECTIVE

Malnutrition is a common condition among elderly cancer patients. The Geriatric Nutritional Risk Index (GNRI) is a simple screening tool used to predict the risk of postoperative complications in patients undergoing radical cystectomy. This study aimed to evaluate the effectiveness of preoperative GNRI as a marker for predicting 90-day postoperative complications in elderly patients undergoing robot-assisted radical cystectomy (RARC).

METHODS

We retrospectively evaluated 385 patients who underwent RARC at four affiliated institutes of Tokushima University between 2014 and 2023. Patient background characteristics, pathological findings, and 90-day postoperative complications were analyzed. Preoperative GNRI was calculated using serum albumin and body mass index, with an abnormal nutritional status defined as GNRI < 92.

RESULTS

A total of 166 patients aged ≥ 75 years who underwent RARC were included in the study. Among these, 26 patients (15.7%) had an abnormal GNRI. Eighty-four patients (50.6%) experienced complications within 90 days postoperatively, including 29 patients (17.5%) with major complications (Clavien-Dindo classification ≥ 3). The 90-day postoperative mortality rate was 3.0% (five patients). Patients with an abnormal GNRI had a significantly higher rate of 90-day postoperative complications (p < 0.001). Multivariable logistic regression analysis identified abnormal GNRI as a significant predictor of 90-day postoperative complications (odds ratio: 9.963; 95% confidence interval: 2.125-46.718; p = 0.004).

CONCLUSIONS

Poor nutritional status is associated with a higher rate of 90-day postoperative complications in elderly patients undergoing RARC. Preoperative GNRI may be a useful tool for assessing the risk of complications in this patient population.