Association of the Geriatric Nutritional Risk Index and Postoperative Complications in Head and Neck Cancer

Background: Malnutrition is associated with increased morbidity and mortality in patients with head and neck cancer (HNC) undergoing surgery. The ability to identify patients who are malnourished with an objective measure is currently a barrier to prompt screening and interventions. Recognizing the need for a screening tool, we used the geriatric nutritional risk index (GNRI) to assess the prevalence of malnutrition and the association between postoperative complications and GNRI scores. Methods: A retrospective review of medical records was conducted at a tertiary care academic hospital. A total of 49 HNC patients undergoing surgery with a serum albumin obtained within 6 months of surgery were included in this study. GNRI was calculated as follows: (1.487 × serum albumin [g/L] + (41.7 × current weight/ideal body weight [kg]). Analyses were conducted using univariate statistical methods. Results: 49 patients were included in the study, 32 men (65%) and 17 women (35%), with a mean age of 63 + 12 years. Malnutrition was defined by a GNRI score of < 97.5 and was present in 24% of patients (n = 12). Malnourished patients had significantly higher rates of postoperative complications and discharge to a skilled nursing facility (SNF) compared to controls. Conclusions: A low GNRI score appears to be a predictor of increased complications after head and neck surgery. The GNRI is a simple tool that requires serum albumin, current body weight, and ideal body weight to objectively assess nutrition status. Further studies are needed to assess the utility of using GNRI to assess malnutrition and identify patients who are at high risk for complications during the postoperative course.