Postoperative Geriatric Nutritional Risk Index Predicts of Anastomotic Leakage in Patients Undergoing Colorectal Cancer Surgery

Purpose: To evaluate the predictive value of the postoperative Geriatric Nutritional Risk Index (GNRI) for anastomotic leakage (AL) compared with traditional nutritional indicators (albumin and body mass index [BMI]) in patients undergoing radical colorectal cancer (CRC) surgery. Methods: This retrospective study analyzed 302 consecutive patients who underwent laparoscopic radical CRC surgery at Yanbian University Hospital from January 2022 to October 2024. Clinical characteristics, preoperative laboratory data, and postoperative outcomes were collected. GNRI was calculated as GNRI = [1.489 × albumin (g/L)] + [41.7 × (actual weight/ideal weight)]. Receiver operating characteristic (ROC) curves identified the optimal GNRI cut-off value for predicting AL, and logistic regression analyses were performed to identify independent predictors of AL. Results: Anastomotic leakage occurred in 16 patients (5.3%). ROC analysis established a postoperative GNRI cut-off value of 90.64, with a sensitivity of 64.7% and specificity of 75.0%. Multivariate logistic regression showed that tumor size (>5 cm) (OR=3.664, 95% CI: 1.222–10.980, p=0.020) and postoperative GNRI ≤90.64 (OR=5.495, 95% CI: 1.653–18.182, p=0.005) were significant independent predictors of AL. Neither albumin nor BMI alone independently predicted AL. Conclusion: The postoperative GNRI is a superior predictor of anastomotic leakage following CRC surgery compared to traditional nutritional indicators such as albumin and BMI alone. Routine GNRI evaluation after surgery could help clinicians identify high-risk patients earlier, enabling timely nutritional interventions and potentially improving postoperative outcomes.