(249) Impact of Geriatric Nutritional Risk Index on Parotidectomy Outcomes

Monday, October 2, 2023

2:45 PM – 3:45 PM East Coast USA Time

Has Audio

Presenting Author(s)

Owais M. Aftab, BS

Medical Student
Department of Otolaryngology – Head and Neck Surgery, Rutgers New Jersey Medical School
Newark, New Jersey, United States

Co-Author(s)

SC

Sree C. Chinta, BS

Medical Student
Department of Otolaryngology – Head and Neck Surgery, Rutgers New Jersey Medical School
Newark, New Jersey, United States
IH

Isabel Herzog, BA

Department of Otolaryngology – Head and Neck Surgery, Rutgers New Jersey Medical School, USA
DM

Dhruv Mendiratta, BS

Department of Otolaryngology – Head and Neck Surgery, Rutgers New Jersey Medical School, USA
ML

Mehdi S. Lemdani, BA

Medical Student
Department of Otolaryngology – Head and Neck Surgery, Rutgers New Jersey Medical School
Woodbridge, New Jersey, USA
Jean Anderson Eloy, MD, FACS, FACS

Distinguished Professor and Vice Chair of Otolaryngology - Head and Neck Surgery
Department of Otolaryngology – Head and Neck Surgery, Rutgers New Jersey Medical School
West Orange, New Jersey, United States

Senior Author(s)

Christina H. Fang, MD

Assistant Professor
Albert Einstein College of Medicine/Montefiore Medical Center
Bronx, NY, United States

Disclosure(s):

Owais M. Aftab, BS: No relevant relationships to disclose.

Sree C. Chinta, BS: No relevant relationships to disclose.

Jean Anderson Eloy, MD, FACS, FACS: No relevant relationships to disclose.

Christina H. Fang, MD: No relevant relationships to disclose.

Introduction: The geriatric nutritional risk index (GNRI) is an elderly-specific index useful in assessing nutrition-related risks. This study seeks to analyze the association between the geriatric nutritional risk index (GNRI) and adverse outcomes in patients undergoing parotidectomy using a national database.

Methods: This retrospective cohort analysis utilized the 2005-2018 National Surgery Quality Improvement Program (NSQIP) database. Current Procedural Terminology (CPT) codes were used to identify cases of parotidectomy (42410, 42415, 42420, 42425, 42426) in patients aged over 65 years of age. Demographics and comorbidities were compared between well-nourished patients (WN) (GNRI greater than 73), and severely malnourished patients (MN) (GNRI less than 73,) using unadjusted chi-square analysis. Propensity score matching was used to adjust for covariates. The independent impact of malnutrition was evaluated using chi-square testing on the adjusted, propensity-score matched dataset.

Results: 1,049 (77.1%) WN and 312 (22.9%) MN patients underwent parotidectomy from 2005 to 2018. Well-nourished patients had a significantly higher proportion of female sex (p=0.049) and Hispanic ethnicity (p=0.024). Chi-square analysis indicated MN patients more likely had congestive heart failure (1.9% vs. 0.2%; p=0.003). A propensity score matched subset of 240 WN (49.1%) and 249 MN (50.9%) patients had no significantly varying demographics factors or comorbidities. After adjustment for confounders, chi-square analysis indicated malnutrition (low GNRI) is an independent risk factor for prolonged length of stay (OR 2.48; 1.12 - 5.50; p=0.025).

Conclusions: Malnutrition, represented by low GNRI is associated with an increased risk of prolonged length of stay in elderly patients undergoing parotidectomy. Preoperative optimization of a patient’s nutritional status can possibly prevent these adverse outcomes.