The Role of Geriatric Nutritional Risk Index in Predicting Postoperative Pulmonary Complications in Elderly Lung Cancer Patients Undergoing Surgical Resection

Background: The relationship between immunonutritional status (eg. Prognostic nutritional index [PNI] and Controlling Nutritional Status [COUNT] score) and risk of postoperative pulmonary complications (PPCs) after surgical resection of lung cancer had reported before. However, another immunonutritional parameter- Geriatric Nutritional Risk Index (GNRI)-had never explored.Method: To address this issue, in this study we retrospectively analyzed patients’ characteristics and PPCs in a cohort of lung cancer patients who were treated by surgical resection at our center. The clinical utility of patients’ characteristics for predicting PPCs was evaluated by receiver operating characteristic curve analysis and the Youden index. Univariate and multivariate analysis were applied to find the most important factors.Result: A total of 128 patients met the inclusion criteria for this study. Significant differences in sex, GNRI, FEV1%, LY% were found between the PPC and non-PPC groups (all P<0.05). The difference in pathology between the 2 groups showed borderline statistical significance (P=0.052). We determined the best cutoff value of each parameter and calculated the corresponding sensitivity and specificity, and found that GNRI, FEV1% and LY% had similar diagnostic value. Multivariate analysis reveled GNRI, sex, LY% and FEV1% were filtered to be correlated to PPCs of elderly lung cancer patients received surgery therapy.Conclusion: These results indicate that preoperative immunonutritional parameters of GNRI can be used to identify elderly lung cancer patients at risk of PPCs.