GNRI predicts outcomes in bladder cancer after radical cystectomy

Nutritional status evaluated by the Genetic Nutritional Risk Index (GNRI) can predict complications within 30 days following radical cystectomy (RC), suggests a study.

A team of investigators determined whether preoperative GNRI was associated with 30-day complications after RC. They identified patients aged ≥65 years who underwent RC for the treatment of bladder cancer between 2007 and 2019 using the American College of Surgeons National Surgical Quality Improvement Program database.

Patients were divided into at-risk (GNRI ≤98) or no-risk (GNRI >98) groups. The two cohorts were compared using propensity score matching for baseline differences and 30-day outcomes. Using multivariable logistic regression analysis, the investigators assessed GNRI as an independent predictor of postoperative complication.

A total of 2,926 patients met the eligibility criteria. After propensity score matching, the at-risk group showed higher rates of any complication (p=0.017), blood transfusion (p=0.002), extended length of stay (p=0.004), and nonhome discharge (p<0.001).

On multivariable logistic regression analysis, a decreasing GNRI independently predicted mortality (odds ratio [OR], 1.05, 95 percent confidence interval [CI], 1.01‒1.08; p=0.009), blood transfusion (OR, 1.03, 95 percent CI, 1.02‒1.04; p<0.001), pneumonia (OR, 1.04, 95 percent CI, 1.01‒1.07; p=0.013), extended length of stay (OR, 1.03, 95 percent CI, 1.02‒1.05; p<0.001), and nonhome discharge (OR, 1.04, 95 percent CI, 1.03‒1.06; p<0.001).

“The GNRI is a simple screening tool to predict nutrition-related risk of morbidity and mortality in older patients,” the investigators said.