An easy-to-use tool may identify patients older than 65 years with malnutrition prior to radical cystectomy (RC), investigators reported at the 22nd annual meeting of the Society of Urologic Oncology.

The Geriatric Nutritional Risk Index (GNRI) incorporates patients’ serum albumin concentration, present height and weight, and ideal weight. A GNRI of 98 or less indicates poor nutrition, whereas a GNRI exceeding 98 indicates good nutrition, according to investigators.

In a propensity score-matched cohort from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), 687 patients had an at-risk GNRI of 98 or less and 687 had a no-risk GNRI exceeding 98. The at-risk group had significantly higher rates of any postoperative complication (70.2% vs 62.3%), blood transfusion (46.1% vs 35.8%), and deep venous thrombosis requiring therapy (3.2% vs 1.5%), Carlos Riveros, MD, of the University of Florida Health, reported in a poster presentation. The at-risk group also had significantly higher mortality (3.8% vs 1.7%), extended length of stay (34.4% vs 26.9%), and non-home discharge (21.3% vs 15.1%), he said.

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“The association between malnutrition and complications following major urologic surgery is well known to urologists. However, there is a need for an easy and objective tool to assess malnutrition in elderly patients,” Dr Riveros said in an interview. “The Geriatric Nutritional Risk Index could be used to counsel patients prior to radical cystectomy and identify patients who might benefit from a referral to a dietitian. Perioperative immuno-nutritional intervention has already been shown to impact outcomes after RC, and the GNRI could be used to evaluate the success of preoperative nutritional support.”


Riveros C, Jazayeri SB, Chalfant V, et al. The geriatric nutritional risk index predicts postoperative complications in patients with bladder cancer after radical cystectomy: a propensity score matched analysis of NSQIP data. Presented at the 22nd annual meeting of the Society of Urologic Oncology. December 1-3, 2021. Poster 43.