The Effect of Nutritional Status on Postoperative Mortality and Morbidity in the Geriatric Population Undergoing Gastrointestinal Surgery

Effects of the Geriatric Nutritional Risk Index (GNRI), Mini Nutritional Assessment-Short Form (mNA-SF), and Systemic Immune-Inflammation Index (SII) on Postoperative Morbidity and Mortality in Geriatric Patients Undergoing Gastrointestinal Surgery

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.

Study Overview

• Status: Active, not recruiting
• Conditions: Nutrition Assessment; Geriatric Anesthesia
• Intervention / Treatment: Other: Preoperative Risk Scoring; Other: Postoperative Morbidite and Mortality Monitoring; Other: Delirium Assessment Protocol

Detailed Description

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 (Estimated): 200

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Kartal
    • Istanbul, Kartal, Turkey (Türkiye), 34890
      • Kartal Dr. Lütfi Kirdar City Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Geriatric patients scheduled for gastrointestinal surgery at a single-center tertiary care urban hospital (SBÜ Kartal Dr. Lütfi Kırdar City Hospital).".

Description

Inclusion Criteria:

• Patients scheduled to undergo gastrointestinal surgery.

Age 65 years and older.

ASA (American Society of Anesthesiologists) physical status class 3 or 4.

Mini-Mental State Examination (MMSE) score of 21 or higher

Exclusion Criteria:

• Patients who do not consent to participate in the study.

Patients with acute infection during the preoperative period.

Patients who received albumin replacement in the preoperative period.

Patients with a Mini-Mental State Examination (MMSE) score below 21.

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Geriatric Gastrointestinal Surgery Patients.; This group consists of 200 geriatric patients aged 65 and older who are scheduled to undergo gastrointestinal surgery. Participants are within the ASA 3-4 risk groups and must have a Mini-Mental State Examination (MMSE) score of 21 or higher to be included.

Other: Preoperative Risk Scoring; 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).; Other: Postoperative Morbidite and Mortality Monitoring; 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.; Other: Delirium Assessment Protocol; 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).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Systemic Immune-Inflammation Index (SII)	Calculated as (Platelets x Neutrophils) / Lymphocytes from preoperative blood samples.The unit of measure is cells per microliter.	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.	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.	Preoperative (Baseline)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postoperative Morbidity	Monitoring of pulmonary (e.g., pneumonia, embolism) and extrapulmonary (e.g., surgical site infection, organ failure, anastomosis leak) complications	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).	Preoperative to discharge
Length of Hospital and ICU Stay	Recording the number of days spent in the hospital and intensive care unit.	Total duration of hospitalization
Postoperative Mortality Rate	Tracking patient survival rates at specified intervals after the operation.	30, 60, and 90 days post-surgery

Collaborators and Investigators

• Sponsor: Dr. Lutfi Kirdar Kartal Training and Research Hospital
• Investigators: Principal Investigator: Minel N KUTUPOGLU SEZER, MD, University of Health Sciences, Kartal Dr. Lutfi Kirdar City Hospital

Study record dates

Study Major Dates

• Study Start (Actual): February 1, 2025
• Primary Completion (Actual): February 1, 2025
• Study Completion (Estimated): May 30, 2026

Study Registration Dates

• First Submitted: January 20, 2026
• First Submitted That Met QC Criteria: January 20, 2026
• First Posted (Actual): January 28, 2026

Study Record Updates

• Last Update Posted (Actual): January 30, 2026
• Last Update Submitted That Met QC Criteria: January 28, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Keywords: Mortality; Geriatric; Nutritional; Gastrointestinal surgery
• Other Study ID Numbers: KARTALANESTEZİ088

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: De-identified individual participant data that underlie the results reported in this article (text, tables, figures, and appendices) will be shared.
• IPD Sharing Time Frame: Beginning 6 months and ending 36 months following article publication.
• IPD Sharing Access Criteria: Researchers who provide a methodologically sound proposal to achieve aims in the approved proposal.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No