Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jul 27, 2025; 17(7): 106341
Published online Jul 27, 2025. doi: 10.4240/wjgs.v17.i7.106341
Effect of graded nutritional intervention on elderly colorectal cancer patients’ postop status
Sha-Sha Ni, Yan Du
Sha-Sha Ni, Yan Du, Department of General Surgery Three, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
Author contributions: Ni SS collected the data; Du Y designed the research; Ni SS and Du Y analyzed the data and wrote the manuscript; and all authors have read and approve the final manuscript.
Institutional review board statement: This study was approved by the Medical Ethics Committee of The First Affiliated Hospital of Soochow University, approval No. (2020) 076.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan Du, Nurse-in-charge, Department of General Surgery Three, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou 215000, Jiangsu Province, China. duyan3963@163.com
Received: April 1, 2025
Revised: April 26, 2025
Accepted: June 6, 2025
Published online: July 27, 2025
Processing time: 113 Days and 2.7 Hours
Abstract
BACKGROUND

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.

AIM

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

METHODS

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.

RESULTS

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).

CONCLUSION

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.

Keywords: Geriatric nutritional risk index; Graded nutritional intervention; Elderly colorectal cancer; Postoperative; Nutritional status; Quality of life

Core Tip: A total of 135 elderly colorectal cancer patients subjected to radical resection at our hospital between September 2022 and December 2024 were involved in the retrospective study. In this research, comparisons were made regarding clinical indicators, nutritional status, quality of life, immune function, inflammatory factor levels, and the incidence of complications between the two groups. Results showed geriatric nutritional risk index - based graded nutritional intervention improved clinical indicators, nutrition, and quality of life, promoted immune recovery, alleviated inflammation, reduced complications, confirming its reliability as a postoperative strategy.