Effect of preoperative nutritional risk index on 30-day postoperative complications in patients with gastric cancer: a retrospective cohort study

BackgroundPreoperative nutritional status in patients with gastric cancer after surgery has attracted considerable interest. The nutritional risk index (NRI) has been widely used as a convenient and effective nutritional assessment index, but the relationship between preoperative NRI and postoperati...

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Main Authors: Yingfeng Zou, Ling Li, Kui Jia, Lei Tian, Minying He, Debin Huang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1475381/full
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author Yingfeng Zou
Ling Li
Kui Jia
Lei Tian
Minying He
Debin Huang
author_facet Yingfeng Zou
Ling Li
Kui Jia
Lei Tian
Minying He
Debin Huang
author_sort Yingfeng Zou
collection DOAJ
description BackgroundPreoperative nutritional status in patients with gastric cancer after surgery has attracted considerable interest. The nutritional risk index (NRI) has been widely used as a convenient and effective nutritional assessment index, but the relationship between preoperative NRI and postoperative complications in patients with gastric cancer has not been adequately studied. Our study aimed to investigate the effects of preoperative NRI on 30-day postoperative complications in patients with gastric cancer.MethodsThis retrospective analysis investigated 578 patients with gastric cancer. Preoperative NRI calculations were based on serum albumin levels and body weight, and receiver operating characteristic curves were used in analyzing NRI values and establishing optimal cutoff points. Patients were categorized into two groups according to cutoff value: low NRI group (NRI<96.7) and high NRI group (NRI≥96.7). The hazard ratio (HR) for postoperative complications was calculated through Cox regression analysis and adjusted for potential confounders, and the effects of NRI on postoperative complications in patients with gastric cancer were examined. In addition, we conducted subgroup analyses to examine whether there was an interaction between the effect of NRI on the cumulative incidence of postoperative complications and other confounding factors.ResultsOf the 578 patients with gastric cancer who underwent radical surgery, 120 (20.8%) experienced postoperative complications. The optimal NRI threshold of 96.7 was identified using ROC curve analysis. Cox regression analysis demonstrated that preoperative NRI was independently associated with 30-day postoperative complications after adjusting for confounding factors (HR=0.93; 95%CI: 0.90–0.96; P<0.001). Patients in the low NRI group had significantly higher rates of postoperative complications than those in the high NRI group(HR=2.89, 95%CI:1.71–4.88; P<0.001). The cumulative incidence analysis revealed a higher risk of postoperative complications over time in the low NRI group compared with the high NRI group (P<0.001). These associations remained robust in subgroup analyses.ConclusionsNRI is an independent predictor of 30-day postoperative complications in gastric cancer patients and is a convenient and useful nutritional screening tool for identifying patients with gastric cancer at high risk of postoperative complications.
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spelling doaj-art-80e92bf58bdc423ba5da5cc1d4cc0c982025-08-20T02:06:47ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-06-011510.3389/fonc.2025.14753811475381Effect of preoperative nutritional risk index on 30-day postoperative complications in patients with gastric cancer: a retrospective cohort studyYingfeng Zou0Ling Li1Kui Jia2Lei Tian3Minying He4Debin Huang5Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, ChinaDepartment of Nursing, The First Affiliated Hospital of Guangxi Medical University, Nanning, ChinaDepartment of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, ChinaDepartment of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, ChinaDepartment of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, ChinaDepartment of Nursing, The First Affiliated Hospital of Guangxi Medical University, Nanning, ChinaBackgroundPreoperative nutritional status in patients with gastric cancer after surgery has attracted considerable interest. The nutritional risk index (NRI) has been widely used as a convenient and effective nutritional assessment index, but the relationship between preoperative NRI and postoperative complications in patients with gastric cancer has not been adequately studied. Our study aimed to investigate the effects of preoperative NRI on 30-day postoperative complications in patients with gastric cancer.MethodsThis retrospective analysis investigated 578 patients with gastric cancer. Preoperative NRI calculations were based on serum albumin levels and body weight, and receiver operating characteristic curves were used in analyzing NRI values and establishing optimal cutoff points. Patients were categorized into two groups according to cutoff value: low NRI group (NRI<96.7) and high NRI group (NRI≥96.7). The hazard ratio (HR) for postoperative complications was calculated through Cox regression analysis and adjusted for potential confounders, and the effects of NRI on postoperative complications in patients with gastric cancer were examined. In addition, we conducted subgroup analyses to examine whether there was an interaction between the effect of NRI on the cumulative incidence of postoperative complications and other confounding factors.ResultsOf the 578 patients with gastric cancer who underwent radical surgery, 120 (20.8%) experienced postoperative complications. The optimal NRI threshold of 96.7 was identified using ROC curve analysis. Cox regression analysis demonstrated that preoperative NRI was independently associated with 30-day postoperative complications after adjusting for confounding factors (HR=0.93; 95%CI: 0.90–0.96; P<0.001). Patients in the low NRI group had significantly higher rates of postoperative complications than those in the high NRI group(HR=2.89, 95%CI:1.71–4.88; P<0.001). The cumulative incidence analysis revealed a higher risk of postoperative complications over time in the low NRI group compared with the high NRI group (P<0.001). These associations remained robust in subgroup analyses.ConclusionsNRI is an independent predictor of 30-day postoperative complications in gastric cancer patients and is a convenient and useful nutritional screening tool for identifying patients with gastric cancer at high risk of postoperative complications.https://www.frontiersin.org/articles/10.3389/fonc.2025.1475381/fullgastric cancernutritional risk indexpostoperative complicationsurgerycancer
spellingShingle Yingfeng Zou
Ling Li
Kui Jia
Lei Tian
Minying He
Debin Huang
Effect of preoperative nutritional risk index on 30-day postoperative complications in patients with gastric cancer: a retrospective cohort study
Frontiers in Oncology
gastric cancer
nutritional risk index
postoperative complication
surgery
cancer
title Effect of preoperative nutritional risk index on 30-day postoperative complications in patients with gastric cancer: a retrospective cohort study
title_full Effect of preoperative nutritional risk index on 30-day postoperative complications in patients with gastric cancer: a retrospective cohort study
title_fullStr Effect of preoperative nutritional risk index on 30-day postoperative complications in patients with gastric cancer: a retrospective cohort study
title_full_unstemmed Effect of preoperative nutritional risk index on 30-day postoperative complications in patients with gastric cancer: a retrospective cohort study
title_short Effect of preoperative nutritional risk index on 30-day postoperative complications in patients with gastric cancer: a retrospective cohort study
title_sort effect of preoperative nutritional risk index on 30 day postoperative complications in patients with gastric cancer a retrospective cohort study
topic gastric cancer
nutritional risk index
postoperative complication
surgery
cancer
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1475381/full
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