Background:The Geriatric Nutritional Risk Index (GNRI) is a simple tool for nutritional assessment, but its long-term prognostic value in patients undergoing pancreaticoduodenectomy (PD) remains unclear.Methods: This retrospective study included adult patients who underwent PD between January 2014 and December 2023 at Chang Gung Memorial Hospital. Patients were grouped by GNRI: inferior (<82), moderate (82–98), and superior (≥98). Propensity score matching was performed based on age, sex, cancer type, surgical approach, and ASA status. Primary outcomes were overall survival (OS) and recurrence-free survival (RFS).Results: Among 371 patients, inferior GNRI was associated with worse median survival time (18.64 vs. 34.62 months, HR = 2.953,p< 0.001). This association was observed in both pancreatic cancer and other periampullary malignancies. Inferior GNRI also correlated with higher short-term mortality and adverse perioperative outcomes, including longer ICU stay, and greater need for ventilator support, reintubation, reoperation and total parenteral nutrition (TPN).Conclusions: Preoperative GNRI is a strong predictor of survival and short-term outcomes in PD patients. Early nutritional assessment may aid risk stratification and intervention.
背景：老年营养风险指数（GNRI）是一种简便的营养评估工具，但其对胰十二指肠切除术（PD）患者长期预后的预测价值尚不明确。 方法：本回顾性研究纳入2014年1月至2023年12月期间在长庚纪念医院接受PD的成年患者。根据GNRI将患者分为三组：低危组（<82分）、中危组（82–98分）和高危组（≥98分）。研究根据年龄、性别、肿瘤类型、手术方式和ASA分级进行倾向评分匹配。主要观察终点为总生存期（OS）和无复发生存期（RFS）。 结果：在371例患者中，低GNRI与较差的中位生存时间相关（18.64个月 vs. 34.62个月，HR = 2.953，p < 0.001）。这一关联在胰腺癌和其他壶腹周围恶性肿瘤中均得到验证。低GNRI还与较高的短期死亡率及不良围手术期结局相关，包括ICU住院时间延长、呼吸机支持需求增加、再插管率升高、再手术率上升以及全肠外营养（TPN）使用增多。 结论：术前GNRI是PD患者生存和短期预后的重要预测指标。早期营养评估可能有助于风险分层和干预措施的制定。
肿瘤(癌症)患者之家