Malnutrition Impacts Surgical Outcomes in Older Patients

Strategic Insights -

New research from the Fujian Cancer Hospital has uncovered a strong association between preoperative nutritional status and surgical outcomes in older patients undergoing non-cardiac surgery. The study examined the relationship between the Geriatric Nutritional Risk Index (GNRI) and the incidence of major adverse cardiovascular and cerebrovascular events (MACCE) in patients aged 65 years or older. The findings suggest that lower preoperative GNRI scores are independently linked with a higher risk of 90-day postoperative MACCE.

Key Takeaways:

  • The study analyzed data from 30,591 patients aged 65 years or older who underwent non-cardiac surgery between 2011 and 2020.
  • Preoperative malnutrition risk was categorized using the GNRI: 4,834 (15.8%) patients were at risk of malnutrition (GNRI < 98), while 25,757 (84.2%) were at no risk of malnutrition (GNRI ≥ 98).
  • The primary outcome was the incidence of 90-day postoperative MACCE, defined as a composite of non-fatal cardiac arrest, angina, acute myocardial infarction, heart failure, new cardiac arrhythmia, stroke, or any combination of these.
  • The 90-day MACCE incidence was 2.1% in patients without risk of malnutrition and 4.4% in those with risk of malnutrition (P < 0.001).
  • Lower preoperative GNRI was independently associated with an increased risk of 90-day postoperative MACCE in older patients undergoing non-cardiac surgery.
  • Incorporating GNRI into risk prediction models alongside factors like the RCRI may improve predictive accuracy for MACCE.

Statistics:

  • 30,591 patients were included in the study.
  • 4,834 (15.8%) patients were at risk of preoperative malnutrition (GNRI < 98).
  • The 90-day MACCE incidence was 2.1% in patients without risk of malnutrition and 4.4% in those with risk of malnutrition (P < 0.001).
  • The association between preoperative GNRI and MACCE was significant in both univariate and multivariate analyses (P < 0.001).

Sources:

  • Association between preoperative geriatric nutritional risk index and major adverse cardiovascular and cerebrovascular events after non-cardiac surgery in older patients: a retrospective cohort study. BMC Geriatrics, 2025, 25(1):1-13. (BMC Geriatrics - http://bmcgeriatr.biomedcentral.com)
  • Dai Z, Wu Y, Huang H, Chen J, Jiang H, Wang Y, Zheng H. Association between preoperative geriatric nutritional risk index and major adverse cardiovascular and cerebrovascular events after non-cardiac surgery in older patients: a retrospective cohort study. BMC Geriatrics, 2025, 25(1):1-13.