Research Article
BibTex RIS Cite

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
https://doi.org/10.5472/marumj.1798655

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.

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
  • 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

Year 2025, Volume: 38 Issue: 3, 209 - 214, 10.10.2025
https://doi.org/10.5472/marumj.1798655

Abstract

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
  • 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
There are 22 citations in total.

Details

Primary Language English
Subjects Surgery (Other)
Journal Section Original Research
Authors

Burcu Özdemir 0000-0002-7486-6590

Deniz Sönmez This is me 0009-0007-2189-4145

Publication Date October 10, 2025
Submission Date August 19, 2025
Acceptance Date September 5, 2025
Published in Issue Year 2025 Volume: 38 Issue: 3

Cite

APA Özdemir, B., & Sönmez, D. (2025). Association between the Geriatric Nutritional Risk Index and the development of pneumothorax after CT-guided transthoracic lung biopsy. Marmara Medical Journal, 38(3), 209-214. https://doi.org/10.5472/marumj.1798655
AMA Özdemir B, Sönmez D. Association between the Geriatric Nutritional Risk Index and the development of pneumothorax after CT-guided transthoracic lung biopsy. Marmara Med J. October 2025;38(3):209-214. doi:10.5472/marumj.1798655
Chicago Özdemir, Burcu, and Deniz Sönmez. “Association Between the Geriatric Nutritional Risk Index and the Development of Pneumothorax After CT-Guided Transthoracic Lung Biopsy”. Marmara Medical Journal 38, no. 3 (October 2025): 209-14. https://doi.org/10.5472/marumj.1798655.
EndNote Özdemir B, Sönmez D (October 1, 2025) Association between the Geriatric Nutritional Risk Index and the development of pneumothorax after CT-guided transthoracic lung biopsy. Marmara Medical Journal 38 3 209–214.
IEEE B. Özdemir and D. Sönmez, “Association between the Geriatric Nutritional Risk Index and the development of pneumothorax after CT-guided transthoracic lung biopsy”, Marmara Med J, vol. 38, no. 3, pp. 209–214, 2025, doi: 10.5472/marumj.1798655.
ISNAD Özdemir, Burcu - Sönmez, Deniz. “Association Between the Geriatric Nutritional Risk Index and the Development of Pneumothorax After CT-Guided Transthoracic Lung Biopsy”. Marmara Medical Journal 38/3 (October2025), 209-214. https://doi.org/10.5472/marumj.1798655.
JAMA Özdemir B, Sönmez D. Association between the Geriatric Nutritional Risk Index and the development of pneumothorax after CT-guided transthoracic lung biopsy. Marmara Med J. 2025;38:209–214.
MLA Özdemir, Burcu and Deniz Sönmez. “Association Between the Geriatric Nutritional Risk Index and the Development of Pneumothorax After CT-Guided Transthoracic Lung Biopsy”. Marmara Medical Journal, vol. 38, no. 3, 2025, pp. 209-14, doi:10.5472/marumj.1798655.
Vancouver Özdemir B, Sönmez D. Association between the Geriatric Nutritional Risk Index and the development of pneumothorax after CT-guided transthoracic lung biopsy. Marmara Med J. 2025;38(3):209-14.