P1057 - EFFECT OF PREOPERATIVE GERIATRIC NUTRITIONAL RISK INDEX ON PROGNOSIS IN PATIENTS AFTER SURGERY FOR LOWER GASTROINTESTINAL PERFORATION

P1057

EFFECT OF PREOPERATIVE GERIATRIC NUTRITIONAL RISK INDEX ON PROGNOSIS IN PATIENTS AFTER SURGERY FOR LOWER GASTROINTESTINAL PERFORATION

M. Hasegawa^1,2,3,*, Y. Sanmoto^1,4, N. Yamauchi^2,3, S. Matsumoto^2,3, N. Sato^2,3

¹Department of Surgery, Takeda General Hospital, Aizuwakamatsu, ²Department of Gastrointestinal Tract Surgery, Fukushima Medical University School of Medicine, Fukushima, ³Department of Gastroenterology, Kita Fukushima Medical Center, Date, ⁴Department of Pediatric Surgery, University of Tsukuba Hospital, Tsukuba, Japan

Rationale: While the Geriatric Nutritional Risk Index (GNRI) has demonstrated prognostic value in various surgical settings, its role in patients undergoing emergency surgery for lower gastrointestinal perforation remains unexplored. This study aimed to evaluate whether preoperative GNRI can predict postoperative outcomes in this high-risk population.

Methods: All adult patients who underwent emergency surgery for lower gastrointestinal perforations between January 2016 and December 2022 at our institution were included. We examined the correlation between preoperative GNRI and postoperative outcomes. Categorical variables were compared using the chi-squared or Fisher’s exact test, and the Mann–Whitney U test was used for nonparametric continuous variables. Multivariate regression analysis was performed to identify factors associated with prolonged hospital stays. Overall survival was assessed with Kaplan–Meier analysis and the log-rank test, using p<0.05 as the threshold for significance.

Results: Eighty patients met the inclusion criteria. Low GNRI scores were significantly associated with increased 1-year mortality (odds ratio 4.0, 95% confidence interval [CI] 1.1–16; p=0.025). Kaplan–Meier analysis with the log-rank test indicated markedly poorer survival in the low-GNRI group compared with the high-GNRI group (12-month survival rate 0.65 [95% CI: 0.47–0.78] vs. 0.88 [95% CI: 0.75–0.95]; p=0.018). Furthermore, both univariate and multivariate analyses demonstrated that lower GNRI scores were associated with prolonged hospital stays.

Conclusion: A low preoperative GNRI score was associated with higher mortality and longer hospital stays following emergency surgery for lower gastrointestinal perforation.

Disclosure of Interest: None declared