Association between the Geriatric Nutritional Risk Index and the development of pneumothorax after CT-guided transthoracic lung biopsy

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.