Postoperative pulmonary complications (PPCs), such as pneumonia, atelectasis, and respiratory failure, are major causes of illness, prolonged hospital stays, and intensive care admissions in older patients undergoing elective major abdominal surgery. The American Society of Anesthesiologists Physical Status (ASA-PS) classification is commonly used before surgery to estimate risk. However, ASA-PS does not directly measure nutritional depletion or muscle weakness, which are critical risk factors in geriatric patients.
The Geriatric Nutritional Risk Index (GNRI) is a simple, objective screening tool calculated from preoperative serum albumin levels and body weight.
The purpose of this observational study is to evaluate the role of GNRI in predicting postoperative pulmonary complications and to determine whether adding GNRI to the standard ASA-PS classification improves the ability to identify older patients at high risk for lung complications after major abdominal surgery.
Age 65 years or older.
Scheduled for elective major abdominal surgery under general anesthesia, including colorectal surgery, gastrectomy, pancreatic surgery, or major hepatobiliary resection.
American Society of Anesthesiologists Physical Status (ASA-PS) class I, II, III, or IV.
Informed consent provided by the participant or their legal representative.
Emergency surgery.
Minor or superficial procedures that do not require major intra-abdominal surgery, such as diagnostic laparoscopy, simple laparoscopic cholecystectomy, or simple hernia repair.
Active pneumonia or acute respiratory failure before surgery.
Missing preoperative serum albumin, body weight, or height measurements.
The study population will consist of adults aged 65 years or older who are scheduled to undergo elective major abdominal surgery under general anesthesia at Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital in Ankara, Turkey. Eligible participants will be enrolled consecutively after informed consent is obtained from the participant or their legal representative. Major procedures may include colorectal surgery, gastrectomy, pancreatic surgery, and major hepatobiliary resection. Patients undergoing emergency or minor surgery, those with active pneumonia or acute respiratory failure before surgery, and those with missing preoperative albumin, weight, or height data will be excluded.
Cohort
Prospective
Not listed
Incidence of Postoperative Pulmonary Complications Within 30 Days
The proportion of participants who develop at least one postoperative pulmonary complication within 30 days after surgery. Complications, including pneumonia, atelectasis, respiratory failure, or reintubation, will be identified according to the European Perioperative Clinical Outcome (EPCO) consensus definitions using hospital records and the planned 30-day follow-up.
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