Effect of graded nutritional intervention on elderly colorectal cancer patients' postop status

Colorectal cancer (CRC) is a globally prevalent gastrointestinal malignant cancer, especially in elderly patients. Currently, surgery resection remains the primary treatment due to its favorable therapeutic outcomes. However, postoperative deterioration in nutritional status and quality of life (QoL) remains a concern. The geriatric nutritional risk index (GNRI), which is calculated based on serum albumin levels and the ratio of normal body weight to ideal body weight, is easily accessible and accurate, making it increasingly popular in clinical practice.

To investigate the impact of GNRI-guided tiered nutritional interventions on postoperative nutritional recovery and QoL in elderly CRC patients.

A retrospective analysis was conducted on 135 elderly CRC patients undergoing radical resection at our hospital from September 2022 to December 2024. Participants were divided into two cohorts: The research group (n = 61) received GNRI-based graded nutritional support, while the control group (n = 65) received conventional nutritional intervention. Clinical indicators, such as postoperative passage of gas by anus, incidence/duration of postoperative fever, hospitalization length and costs, were compared between the two groups. Nutritional biomarkers, including hemoglobin, prealbumin, transferrin, and Patient-Generated Subjective Global Assessment scores were assessed on postoperative day 1 and post-intervention (day 1 after intervention). The Generic QoL Inventory-74 was employed to assess physical function, social function, material life, and psychological function in the two groups. Immunoglobulin (Ig) (IgG, IgA, IgM) and inflammatory markers [nuclear factor kappa B, interleukin (IL)-1, tumor necrosis factor-α, IL-8] were compared between groups. Complication rates were also monitored.

The research group showed significantly faster postoperative passage of gas by anus, fewer instances of fever, reduced fever duration, shorter hospitalization duration, and lower costs compared with the control group (P < 0.05). Following intervention, the research group exhibited higher levels of hemoglobin, prealbumin, and transferrin, and lower Patient-Generated Subjective Global Assessment scores vs the control group (P < 0.05). Scores for physical function, social function, material life, and psychological function showed substantial improvement (P < 0.05). Levels of IgG, IgA, and IgM were significantly elevated in the research group (P < 0.05), while nuclear factor kappa B, IL-1, tumor necrosis factor-α, and IL-8 levels were noticeably lowered vs the control group (P < 0.05). The incidence of overall complications within the research group reached 24.59%, notably lower than that (43.08%) observed in the control group (P < 0.05).

GNRI-based graded nutritional intervention in elderly CRC patients can significantly improve postoperative recovery, enhance their nutritional status and QoL, promote immune function recovery, attenuate inflammation, and lower the incidence of postoperative complications. This protocol represents a clinically viable strategy for optimizing postoperative care.