Geriatric Nutritional Risk Index and ASA Status for Predicting Lung Complications After Major Abdominal Surgery in Older Adults

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.