Association between the Geriatric Nutritional Risk Index and the development of pneumothorax after CT-guided transthoracic lung biopsy
Year 2025,
Volume: 38 Issue: 3, 209 - 214, 10.10.2025
Burcu Özdemir
,
Deniz Sönmez
Abstract
Objective: The Geriatric Nutritional Risk Index (GNRI) is a simple tool reflecting nutritional and inflammatory status and has been
associated with prognosis in various malignancies. This study aimed to investigate the association between GNRI and the development
of post-procedural pneumothorax (PTX) after computed tomography (CT)-guided transthoracic lung biopsy (TTLB).
Patients and Methods: This retrospective study included 60 patients who underwent CT-guided TTLB, of whom 23 developed PTX
(mean age 67.6±10.4 years; 19 male) and 37 did not (mean age 64.4±10.2 years; 26 male). Demographic, clinical, biochemical, and
radiological data were collected from hospital records. GNRI scores were calculated using serum albumin levels and the ratio of actual
to ideal body weight.
Results: The mean GNRI score was significantly lower in the PTX group compared with the No-PTX group (99.1±15.3 vs. 108.2±12.3,
p=0.014). Patients with PTX also had a longer median pleural distance and a higher proportion of non-pleural-based lesions. Lower
GNRI score (OR: 0.95; 95%CI: 0.91–1.00; p=0.048) and non-pleural-based lesions (OR: 9.77; 95%CI: 1.88–50.64; p=0.007) were
identified as independent predictors of PTX.
Conclusion: Low GNRI and non-pleural-based lesions significantly increase PTX risk. GNRI is an independent predictor and may
serve as a simple and practical tool for pre-procedural risk assessment.
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cancer patients: A systematic review and meta-analysis. Front
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nutritional risk index for patients with non-small cell
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Shoji F, Matsubara T, Kozuma Y, et al. Preoperative
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lung cancer. Surg Oncol 2017;26:483-8. doi:10.1016/j.
suronc.2017.09.006
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Peng SM, Yu N, Ren JJ, et al. The geriatric nutritional risk
index as a prognostic factor in patients with advanced nonsmall-
cell lung cancer. Nutr Cancer 2021;73:2832-41. doi:10.1
080/01635.581.2020.1865423
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Yang M, Liu Z, Li G, et al. Geriatric nutritional risk index
as a prognostic factor of patients with non-small cell lung
cancer: A meta-analysis. Horm Metab Res 2022;54:604-12.
doi:10.1055/a-1903-1943
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Jiang S, Yang A, Yang F, et al. The geriatric nutritional risk
index as a prognostic factor in patients treated with immune
checkpoint inhibitors with non-small-cell lung cancer. J
Thorac Dis 2024;16:5222-37. doi:10.21037/jtd-24-436
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Tang QN, Qiu HZ, Sun XQ, et al. Geriatric nutritional risk
index as an independent prognostic factor in locally advanced
nasopharyngeal carcinoma treated using radical concurrent
chemoradiotherapy: a retrospective cohort study. Ann Transl
Med 2021;9:532. doi:10.21037/atm-20-6493
Year 2025,
Volume: 38 Issue: 3, 209 - 214, 10.10.2025
Burcu Özdemir
,
Deniz Sönmez
References
-
Lee KH, Lim KY, Suh YJ, et al. Diagnostic accuracy
of percutaneous transthoracic needle lung biopsies: A
multicenter study. Korean J Radiol 2019;20:1300-10.
doi:10.3348/kjr.2019.0189
-
Deniz MA, Cakir C, Kurt O, Kilinc F, Deniz Tas Z. CT-guided
lung biopsy: diagnostic accuracy and complication rates of
biopsy techniques. Marmara Med J 2022; 2; 35:219-24. doi:
10.5472/marumj.1120552
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Heerink WJ, de Bock GH, de Jonge GJ, Groen HJ, Vliegenthart
R, Oudkerk M. Complication rates of CT-guided transthoracic
lung biopsy: meta-analysis. Eur Radiol 2017;27:138-48.
doi:10.1007/s00330.016.4357-8
-
Moreland A, Novogrodsky E, Brody L, et al. PTX with
prolonged chest tube requirement after CT-guided
percutaneous lung biopsy: incidence and risk factors. Eur
Radiol 2016;26:3483-91. doi:10.1007/s00330-015-4200-7
-
Huo YR, Chan MV, Habib AR, Lui I, Ridley L. PTX rates in CTGuided
lung biopsies: a comprehensive systematic review and
meta-analysis of risk factors. Br J Radiol 2020;93:20190866.
doi:10.1259/bjr.20190866
-
Lee HY, Lee IJ. Assessment of independent risk factors of
developing PTX during percutaneous core needle lung
biopsy: Focus on lesion depth. Iran J Radiol 2016;13:e30929.
doi:10.5812/iranjradiol.30929
-
Drumm O, Joyce EA, de Blacam C, et al. CT-guided lung
biopsy: Effect of biopsy-side down position on PTX and chest
tube placement. Radiology 2019;292:190-6. doi:10.1148/
radiol.201.918.2321
-
Bouillanne O, Morineau G, Dupont C, et al. Geriatric
Nutritional Risk Index: a new index for evaluating at-risk
elderly medical patients. Am J Clin Nutr 2005;82:777-83.
doi:10.1093/ajcn/82.4.777
-
Soeters PB, Wolfe RR, Shenkin A. Hypoalbuminemia:
Pathogenesis and clinical significance. JPEN J Parenter Enteral
Nutr. 2019;43:181-93. doi:10.1002/jpen.1451
-
Wang H, Li C, Yang R, Jin J, Liu D, Li W. Prognostic value
of the geriatric nutritional risk index in non-small cell lung
cancer patients: A systematic review and meta-analysis. Front
Oncol 2022;11:794862. doi:10.3389/fonc.2021.794862
-
Shen F, Ma Y, Guo W, Li F. Prognostic value of geriatric
nutritional risk index for patients with non-small cell
lung cancer: A systematic review and meta-analysis. Lung
2022;200:661-9. doi:10.1007/s00408.022.00567-6
-
Wang B, Wang Z, Xu C, et al. Geriatric Nutritional Risk
Index is an effective prognostic predictor for metastatic/
recurrent or unresectable esophageal cancer receiving
immunotherapy. J Gastrointest Oncol 2025;16:1-16.
doi:10.21037/jgo-24-722
-
Shoji F, Miura N, Matsubara T, et al. Prognostic significance
of immune-nutritional parameters for surgically resected
elderly lung cancer patients: a multicentre retrospective
study. Interact Cardiovasc Thorac Surg 2018;26:389-94.
doi:10.1093/icvts/ivx337
-
Abd-El-Gawad WM, Abou-Hashem RM, El Maraghy MO,
Amin GE. The validity of Geriatric Nutrition Risk Index:
simple tool for prediction of nutritional-related complication
of hospitalized elderly patients. Comparison with Mini
Nutritional Assessment. Clin Nutr 2014;33:1108-16.
doi:10.1016/j.clnu.2013.12.005
-
Wang MH, Chen CY, Lin YH, et al. High geriatric nutritional
risk index risk as a predictor of postoperative complications
and early mortality in older adult patients undergoing
pancreatoduodenectomy for periampullary malignancies. J
Clin Med 2025;14:655. doi:10.3390/jcm14020655
-
Zhao W, Liu L, Zhang J, et al. Preoperative geriatric nutritional
risk index predicts prognosis and postoperative complications
in elderly patients undergoing non-cardiac surgery: a
retrospective cohort study. BMC Geriatr 2025;25:101.
doi:10.1186/s12877.024.05667-x
-
Yamana I, Takeno S, Shibata R, et al. Is the geriatric
nutritional risk index a significant predictor of postoperative
complications in patients with esophageal cancer
undergoing esophagectomy? Eur Surg Res 2015;55:35-42.
doi:10.1159/000376610
-
Shoji F, Matsubara T, Kozuma Y, et al. Preoperative
geriatric nutritional risk index: A predictive and prognostic
factor in patients with pathological stage I non-small cell
lung cancer. Surg Oncol 2017;26:483-8. doi:10.1016/j.
suronc.2017.09.006
-
Peng SM, Yu N, Ren JJ, et al. The geriatric nutritional risk
index as a prognostic factor in patients with advanced nonsmall-
cell lung cancer. Nutr Cancer 2021;73:2832-41. doi:10.1
080/01635.581.2020.1865423
-
Yang M, Liu Z, Li G, et al. Geriatric nutritional risk index
as a prognostic factor of patients with non-small cell lung
cancer: A meta-analysis. Horm Metab Res 2022;54:604-12.
doi:10.1055/a-1903-1943
-
Jiang S, Yang A, Yang F, et al. The geriatric nutritional risk
index as a prognostic factor in patients treated with immune
checkpoint inhibitors with non-small-cell lung cancer. J
Thorac Dis 2024;16:5222-37. doi:10.21037/jtd-24-436
-
Tang QN, Qiu HZ, Sun XQ, et al. Geriatric nutritional risk
index as an independent prognostic factor in locally advanced
nasopharyngeal carcinoma treated using radical concurrent
chemoradiotherapy: a retrospective cohort study. Ann Transl
Med 2021;9:532. doi:10.21037/atm-20-6493