Relationship of Geriatric Nutritional Risk Index (GNRI) with length of hospitalization and mortality rate in elderly patients

Abstract

The proportion of elderly population is growing faster than any other age group. Malnutrition is a widespread problem in elderly and has been recognized as the most common cause of mortality and morbidity. Mini Nutritional Assessment (MNA) is recommended to detect malnutrition risk among geriatrics. However, it is just appropriate for geriatric who stay at home. For hospitalization patients, Nutritional Risk Index (NRI) that using albumin and weight is recommended. However, the weight data is often not possible obtained in geriatrics. Therefore, Geriatric Nutritional Risk Index (GNRI) using ideal body weight is recommended. The aim of this study was to evaluate relationship of GNRI with length of hospitalization and mortality rate in geriatric patients. This was an observational study with a prospective cohort design conducted in Dr. Sardjito General Hospital, Yogyakarta from January to February 2012. Patients who met the inclusion and exclusion criteria were recruited. Laboratoty and clinical examinations as well as GNRI scoring were then performed. Patients were grouped into two groups i.e. patients with GNRI score < 82 and e" 82. The patients were then monitored during hospitalization until they were discharged due to die or recovered. The length of stay and patients died were then recorded. The results showed that the length of stay of patients with GNRI score < 82 (14.32 ± 8.20 days) was significantly longer than those with GNRI score 82 (9.31 ± 6.15 days) (p = 0.006). Moreover, the mortality rate of patients with GNRI score < 82 (42.1%) was significantly higher than those with GNRI score 82 (2.8%) (p = 0.000). Kaplan-Meier survival analysis showed survival rate of patients with GNRI score <82 rapidly decreased when compared with those with GNRI score 82. In conclusion, there is negative correlation between GNRI with length of hospitalization and mortality rate in elderly. ABSTRAKProporsi populasi usia lanjut tumbuh lebih cepat dari kelompok usia lain. Malnutrisi menjadi masalah luas pada usia lanjut dan diketahui sebagai penyebab umum kesakitan dan kematian. Mini Nutritional Assessment (MNA) direkomendasikan untuk mendeteksi risiko malnutrisi diantara usia lanjut. Namun demikian, pengukuran ini hanya tepat untuk usia lanjut yang tinggal di rumah. Untuk pasien di rumah sakit, Nutritional Risk Index (NRI) yang menggunakan data albumin dan berat badan direkomendasikan. Akan tetapi data berat badan sering tidak bisa diperoleh pada usia lanjut. Sehingga, Geriatric Nutritional Risk Index (GNRI) menggunakan berat badan ideal direkomendasikan. Tujuan penelitian ini adalah mengkaji hubungan antara GNRI dengan lama tinggal dan kematian pasien usia lanjut. Penelitian ini merupakan penelitian observasional dengan rancangan kohort prospektif yang dilakukan di RSUP Dr. Sardjito, Yogyakarta pada Januari sampai Februari 2012. Pasien yang memenuhi kriteria inklusi dan eksklusi direkrut. Pemeriksaan laboratorium dan klinik dan perhitungan angka GNRI dilakukan. Pasien dikelompokkan menjadi dua kelompok yaitu kelom...

Relationship between Geriatric Nutritional Risk Index, functional dependence, and patient outcome among hospitalized Egyptian septuagenarians.

“…A sample size of at least 100 customers is needed to achieve a 95% confidence level and power 80% when the proportion of deaths account for 16.1% in Ambarukminingsih et al, study [13]. Until the sample size was reached, all eligible patients admitted to the internal ward of the Geriatric hospital were enrolled.…”