Geriatric nutrition risk index is useful to assess the risk of postoperative urinary retention in elderly patient undergoing lumber interbody fusion.

Abstract

Objective: To investigate whether the Geriatric Nutrition Risk Index (GNRI) can serve as an independent predictor of postoperative urinary retention (PUR) in elderly patients undergoing transforaminal lumbar interbody fusion (TLIF).

Methods: This retrospective study reviewed elderly patients who underwent TLIF at a single institution between 2016 and 2021. Patients diagnosed with PUR during hospitalization were identified. GNRI was calculated based on body weight and preoperative serum albumin levels. Multivariate logistic regression analysis was used to determine the association between preoperative GNRI and PUR. Receiver operating characteristic (ROC) curve analysis was conducted to determine the optimal GNRI cutoff value for predicting PUR.

Results: A total of 294 patients met the inclusion criteria. PUR occurred in 47 patients (15.9%). The GNRI was significantly lower in the PUR group compared to the non-PUR group (93.3 ± 7.49 vs. 101.6 ± 6.59, P < 0.001). Multivariate logistic regression analysis confirmed that a lower GNRI independently predicted PUR (OR: 0.763; 95% CI: 0.699-0.834, p < 0.001). ROC analysis identified a GNRI cutoff value of 94.7, with an area under the curve (AUC) of 0.799 ± 0.037.

Conclusion: Lower GNRI is significantly associated with increased risk of PUR following TLIF. GNRI may serve as a useful, independent predictor of PUR risk.