老年人的慢性病患病率明显升高,肿瘤死亡率占老年人全因死亡率的 28. 6%,≥65 岁的外科住院患者已达 25% ~ 33%。 老年患者的手术相关并发症发生率和死亡率、再入院率、医疗费用等均显著增加。 因此,针对外科老年患者选择合适的 营养工具进行术前营养筛查与评价,预判手术风险和结局,加强预康复,对降低术后严重并发症发生率和死亡率、加速康 复,进而显著节约医疗资源和提高社会效益具有重要意义。 本文介绍了我国人口老龄化现状,以及应用消化外科老年患者营 养工具预测围手术期风险和结局。 多项单中心研究提示,老年营养风险指数(GNRI)在预测老年结直肠癌或肝癌等患者围手 术期风险和结局方面具有积极作用,特别是在评价术前营养状况、预测手术相关严重并发症风险、总生存时间和无复发或无 进展生存时间等方面。 在目前检索到的 5 篇荟萃分析显示,总体结论支持以上单中心研究结果。 但也强调了入组荟萃分析的 原始文献多为回顾性文章,病例样本数有限,其整合数据异质性较高。 因此,为客观评价 GNRI 工具,仍需要外科同仁努力开 展多中心、前瞻性、设计良好的临床研究。

The morbidity of the elders with chronic diseases increased obviously. Tumor - related deaths have compromised to 28. 6% of all - cause deaths for elder population. Patients over 65 years old have occupied a ratio about 25% - 33% of all the hospitalized patients in department of surgery. Meanwhile surgery-related complications mortality re-admission rate and commercial burden all increased significantly. For this reason choosing adequate tools aiming at the aged patients for the nutritional screening and evaluation before operation and predicting surgery - related risks and outcomes will contribute crucially to reduce the morbidity of post-operative complications and mortality while enhance prehabilitation efficiently further save medical resources and improve the efficiency of society. This article introduced the circumstance of graying society in China and the evaluations of nutrition tools which aim at elderly patients in Department of Digestive Surgery for prediction perioperative risks and outcomes. Several single -centered researches have implicated that geriatric nutritional risk index GNRI played a positive role in predicting the perioperative risks and outcomes of elderly patients with colorectal cancer or hepatic cell carcinoma. To be specific GNRI may actually be beneficial to evaluate pre - operatively nutritional status and predict the risks of severely surgery - related complications overall survival and recurrence-free or progression - free survival. Five meta - analyses studies searched at present elucidated a common conclusion in consistent with the single-centered researches mentioned above. However the four articles all emphasized that the original researches included in analysis were mostly retrospective designed which means limited sample sizes and high heterogeneity in integrated data. Therefore it still needs efforts of our fellows in surgery to conduct multi-centered prospective well-designed clinical study to evaluate GNRI tools objectively.