Geriatric nutritional risk index significantly associated with major complications after emergency femoral hernia: Study
Researchers have found that the Geriatric Nutritional Risk Index (GNRI) is a valid and easy tool to predict major postoperative complications in patients undergoing emergency surgery for femoral hernias. A recent study was conducted by Qiuyue Ma and colleagues which was published in the journal BMC Surgery.
Emergency femoral hernia surgeries are associated with a significant risk of complications. Effective tools for the identification of patients at increased risk of adverse outcomes would be very helpful in managing the situation better. This study analyzed the prognostic value of GNRI, an index that includes preoperative body weight, height, and serum albumin levels, in predicting postoperative complications among emergency femoral hernia patients.
Methods
This was a cross-sectional study involving 105 patients who had undergone emergency surgery for femoral hernias. GNRI was calculated using the following formula:
GNRI=(1.489×serum albumin[g/L])+(41.7×body weight [kg]/ideal weight [kg]).
Patients were stratified into three nutritional risk categories:
• Low risk: GNRI ≥ 98
• Moderate risk: GNRI 92–97.9
• Severe risk: GNRI < 92
The primary outcome was the incidence of major postoperative complications, which were analyzed using univariable and multivariable logistic regression models. The discrimination of GNRI was evaluated by the area under the curve (AUC).
Key Findings
Prevalence of Nutritional Risk:
• Low risk: 18.1%
• Moderate risk: 25.7%
• Severe risk: 10.5%
Complication Rates:
• Five patients (4.8%) had major postoperative complications.
GNRI and Complication Risk:
• Higher GNRI correlated with lower complication risk.
• Adjusted odds ratio (aOR): 0.90 (95% CI: 0.81–1.00, p=0.044).
Prediction Ability of GNRI
• AUC for GNRI for the complications was 0.812 (95% CI: 0.640–0.984, p=0.019).
• Optimal cut-point: 90.96 (sensitivity: 80.0%; specificity: 72.0%).
There's significant association of GNRI with the risk of developing serious postoperative complications within patients who have emergency femoral hernia. Indeed, as a simple prognostic tool, GNRI serves effectively as a means of clinching clinical results before conducting surgery, thereby exposing a critical role of the nutrition condition in perioperative treatment.
Reference:
Ma, Q., Liu, X., Liang, C. et al. Geriatric nutritional risk index as a predictor of major postoperative complications in emergency femoral hernia patients. BMC Surg 24, 412 (2024). https://doi.org/10.1186/s12893-024-02727-2
