Geriatric Anesthesia, Nutrition Assessment
Conditions
Keywords
Geriatric, Nutritional, Mortality, Gastrointestinal surgery
Brief summary
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.
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.
Interventions
OTHERPreoperative 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).
OTHERPostoperative 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.
OTHERDelirium 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).
Sponsors
Dr. Lutfi Kirdar Kartal Training and Research Hospital
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
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.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Systemic Immune-Inflammation Index (SII) | Preoperative (Baseline) | Calculated as (Platelets x Neutrophils) / Lymphocytes from preoperative blood samples.The unit of measure is cells per microliter. |
| Geriatric Nutritional Risk Index (GNRI) as a predictor of postoperative complications | Preoperative (Baseline) | 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. |
| Mini Nutritional Assessment-Short Form (mNA-SF) score | Preoperative (Baseline) | A 6-question survey to screen for malnutrition.Measured on a scale of 0 to 14 points, where 0-7 indicates malnourishment. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Morbidity | Up to 30 days post-surgery | Monitoring of pulmonary (e.g., pneumonia, embolism) and extrapulmonary (e.g., surgical site infection, organ failure, anastomosis leak) complications |
| Incidence of Delirium | Preoperative to discharge | Assessment of delirium using the Confusion Assessment Method (CAM/CAM-ICU) and Richmond Agitation-Sedation Scale (RASS). |
| Length of Hospital and ICU Stay | Total duration of hospitalization | Recording the number of days spent in the hospital and intensive care unit. |
| Postoperative Mortality Rate | 30, 60, and 90 days post-surgery | Tracking patient survival rates at specified intervals after the operation. |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORMinel N KUTUPOGLU SEZER, MD
University of Health Sciences, Kartal Dr. Lutfi Kirdar City Hospital
Outcome results
None listed