The purpose of this study was to compare the sensitivity and specificity of the Geriatric Nutritional Risk Index (GNRI), Mini Nutritional Assessment Scale-Short Form (mNA-SF) and Systemic Immune-Inflammatory Index (SII) values calculated in the preoperative evaluation in patients over 65 years of age who underwent gastrointestinal surgery, in predicting morbidity and mortality in the postoperative period.
It is crucial to evaluate the impact of nutritional status and systemic inflammation markers on postoperative outcomes in geriatric patients undergoing gastrointestinal surgery. Nutritional status has a decisive impact on the development of morbidity and mortality in geriatric patients. The risk of malnutrition is particularly high in the geriatric patient population undergoing gastrointestinal surgery. Predicting postoperative outcomes in these patient groups is becoming increasingly important. To this end, many different risk scoring systems have been developed. Low nutritional scores and increased inflammatory responses are associated with high mortality, prolonged hospitalization and intensive care unit stays, and complications. The primary goal of preoperative risk scoring is to predict potential complications before, during, and after surgery, and to minimize risks and mortality by attempting to prevent them.
Study Type
OBSERVATIONAL
Enrollment
200
Patients will be evaluated preoperatively using three distinct scoring systems: the Geriatric Nutritional Risk Index (GNRI), the Mini Nutritional Assessment-Short Form (mNA-SF), and the Systemic Immune-Inflammation Index (SII). These scores are calculated based on serum albumin levels, body weight, a 6-question survey, and laboratory values (platelets, neutrophils, and lymphocytes).
Systematic tracking of postoperative outcomes including hospital and ICU stay duration, pulmonary complications (e.g., pneumonia, embolism), extrapulmonary complications (e.g., surgical site infection, organ failure, delirium), and mortality rates at 30, 60, and 90 days.
Patients will be monitored for delirium preoperatively, on the first postoperative day, and before discharge using the Confusion Assessment Method (CAM/CAM-ICU) and the Richmond Agitation-Sedation Scale (RASS).
Kartal Dr. Lutfi Kirdar City Hospital
Istanbul, Kartal, Turkey (Türkiye)
Systemic Immune-Inflammation Index (SII)
Calculated as (Platelets x Neutrophils) / Lymphocytes from preoperative blood samples.The unit of measure is cells per microliter.
Time frame: Preoperative (Baseline)
Geriatric Nutritional Risk Index (GNRI) as a predictor of postoperative complications
GNRI will be calculated using serum albumin and body weight. Scores will be used to categorize patients' nutritional risk.Units on a scale of 0 to 120, where lower scores indicate higher nutritional risk.
Time frame: Preoperative (Baseline)
Mini Nutritional Assessment-Short Form (mNA-SF) score
A 6-question survey to screen for malnutrition.Measured on a scale of 0 to 14 points, where 0-7 indicates malnourishment.
Time frame: Preoperative (Baseline)
Postoperative Morbidity
Monitoring of pulmonary (e.g., pneumonia, embolism) and extrapulmonary (e.g., surgical site infection, organ failure, anastomosis leak) complications
Time frame: Up to 30 days post-surgery
Incidence of Delirium
Assessment of delirium using the Confusion Assessment Method (CAM/CAM-ICU) and Richmond Agitation-Sedation Scale (RASS).
Time frame: Preoperative to discharge
Length of Hospital and ICU Stay
Recording the number of days spent in the hospital and intensive care unit.
Time frame: Total duration of hospitalization
Postoperative Mortality Rate
Tracking patient survival rates at specified intervals after the operation.
Time frame: 30, 60, and 90 days post-surgery
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