The validity of Geriatric Nutrition Risk Index: Simple tool for prediction of nutritional-related complication of hospitalized elderly patients. Comparison with Mini Nutritional Assessment

Abd‐El‐Gawad, Wafaa Mostafa; Abou-Hashem, Rania Mohammed; Maraghy, Mohamed O El; Amin, Ghada Essam El-Din

doi:10.1016/j.clnu.2013.12.005

Cited by 134 publications

(99 citation statements)

References 31 publications

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“…Moreover, GNRI, the nutritional screening tool in our study, was clinically more useful because it is well‐validated, less time‐consuming, and did not require skilled personnel 42. Furthermore, GNRI has a higher prognostic value for classification of nutrition‐related complication in elderly patients than the Mini‐Nutritional Assessment test 27. It should be noted that the ideal BMI in this study was 22 kg/m 2 , which was more appropriate for Asian populations 28.…”

Section: Discussionmentioning

confidence: 76%

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U‐Shaped Association Between Serum Uric Acid Levels With Cardiovascular and All‐Cause Mortality in the Elderly: The Role of Malnourishment

Tseng

Chen

et al. 2018

JAHA

134

103

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BackgroundThe link between elevated serum uric acid (SUA) levels and cardiovascular disease (CVD)–related mortality in the elderly population remains inconclusive. Nutritional status influences both SUA and CVD outcomes. Therefore, we investigated whether SUA‐predicted mortality and the effect‐modifying roles of malnourishment in older people.Methods and ResultsA longitudinal Taiwanese cohort including 127 771 adults 65 years and older participating in the Taipei City Elderly Health Examination Program from 2001 to 2010 were stratified by 1‐mg/dL increment of SUA. Low SUA (<4 mg/dL) strata was categorized by malnourishment status defined as Geriatric Nutritional Risk Index <98, serum albumin <38 g/L, or body mass index <22 kg/m2. Study outcomes were all‐cause and CVD‐related mortality. Cox models were used to estimate hazard ratios (HRs) of mortality, after adjusting for 20 demographic and comorbid covariates. Over a median follow‐up of 5.8 years, there were 16 439 all‐cause and 3877 CVD‐related deaths. Compared with the reference SUA strata of 4 to <5 mg/dL, all‐cause mortality was significantly higher at SUA <4 mg/dL (HR, 1.16; 95% confidence interval, 1.07–1.25) and ≥8 mg/dL (HR, 1.13; confidence interval, 1.06–1.21), with progressively elevated risks at both extremes. Similarly, increasingly higher CVD‐related mortality was found at the SUA level <4 mg/dL (HR, 1.19; confidence interval, 1.00–1.40) and ≥7 mg/dL (HR, 1.17; confidence interval, 1.04–1.32). Remarkably, among the low SUA (<4 mg/dL) strata, only malnourished participants had greater all‐cause and CVD‐related mortality. This modifying effect of malnourishment remained consistent across subgroups.Conclusions SUA ≥8 or <4 mg/dL independently predicts higher all‐cause and CVD‐related mortality in the elderly, particularly in those with malnourishment.

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Section: Discussionmentioning

confidence: 76%

“…A simple and well‐established tool, the Geriatric Nutritional Risk Index (GNRI),26, 27 was used to assess the nutritional risk of each participant and calculated as follows: GNRI=[1.489×albumin (g/L)]+[41.7×(actual weight/ideal weight)] 26. The ideal weight was calculated by the Lorentz formula 26.…”

Section: Methodsmentioning

confidence: 99%

U‐Shaped Association Between Serum Uric Acid Levels With Cardiovascular and All‐Cause Mortality in the Elderly: The Role of Malnourishment

Tseng

Chen

et al. 2018

JAHA

134

103

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“…Identifying possible nutritional risk/malnutrition is 57 important and may affect trajectory of health, morbidity, and mortality [1][2][3][4] . Different 58 screening methods exist including the 'malnutrition universal screening tool' 59 (MUST) 1,5 , the 'mini-nutritional assessment' (MNA) 1,[6][7][8] and the 'geriatric nutritional 60 risk index', (GNRI) 9 . In the United Kingdom (UK), the MUST is the standard routine 61 method of screening in all hospital wards and care homes, although in reality there is 62 no universal gold standard tool 4 .…”

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confidence: 99%

“…An important area to address which overlaps malnutrition is 'cachexia'/'cachexia-79 risk', as acute and chronic illness has a typical effect upon food intake (anorexia) and include important blood markers such as albumin, which is utilised in the GNRI 9 , and 84 is a well known prognostic marker [13][14][15][16] . C-reactive protein (CRP) is another routine 85 blood marker indicating inflammatory status and has known prognostic potential 17,18 .…”

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confidence: 99%

The relationship between malnutrition risk and clinical outcomes in a cohort of frail older hospital patients

Slee

Birch

Stokoe³

2016

Clinical Nutrition ESPEN

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“…Its usefulness in predicting poor outcomes has also been reported for various co-morbidities such as stroke [3], heart failure [4,5], and for hospitalized patients [6,7]. Moreover, GNRI is useful in ascertaining disease prognosis in patients on maintenance dialysis [8][9][10].…”

Section: Introductionmentioning

confidence: 98%

Relationship between mortality and Geriatric Nutritional Risk Index (GNRI) at the time of dialysis initiation: a prospective multicenter cohort study

et al. 2017

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Background: The Geriatric Nutritional Risk Index (GNRI) is a nutritional screening method primarily developed for elderly people; it is also reported to be useful for predicting mortality in patients on maintenance dialysis. However, it is unclear whether it is useful at the time of dialysis initiation, which is accompanied by large weight fluctuations and unstable nutritional status. Methods: The study included 1524 patients with chronic kidney disease who commenced dialysis therapy at 17 centers. Patients commenced dialysis between October 2011 and September 2013 and were followed up until March 2015. Results: We analyzed 1489 patients whose GNRI could be calculated and whose prognosis was clear. The mean GNRI was 87.60 (median 87.86). We divided patients based on the median value into a high (H) and low (L) group. The H group included 728 patients (mean GNRI 95.2 ± 4.9, mean age 65.8 ± 13.2 years, 69.3% men), and the L group included 761 patients (mean GNRI 80.3 ± 6.1, mean age 69.1 ± 12.8 years, 66.0% men). Mortality was significantly higher in the L group (L, 22.2% vs. H, 12.6%, P < 0.001). The rates of infection-associated death in the L group was significantly higher (L, 5.5% vs. H, 1.9%, P < 0.001), although no significant difference was observed regarding cardiovascular disease-associated death (L, 7.6% vs. H, 5.2%, P = 0.059) and malignancy-associated death (L, 3.0% vs. H, 3.0%, P = 1.000). Multivariate analysis showed an association between GNRI and all-cause mortality (HR 0.9852, 95%CI 0.9707-0.9999, P = 0.049) and infection-associated death (HR 0.9484, 95%CI 0.9191-0.9786, P < 0.001). Conclusions: GNRI is useful for predicting mortality even at the time of dialysis initiation. Among the causes of death, GNRI was strongly associated with infection-associated death.

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The validity of Geriatric Nutrition Risk Index: Simple tool for prediction of nutritional-related complication of hospitalized elderly patients. Comparison with Mini Nutritional Assessment

Cited by 134 publications

References 31 publications

U‐Shaped Association Between Serum Uric Acid Levels With Cardiovascular and All‐Cause Mortality in the Elderly: The Role of Malnourishment

U‐Shaped Association Between Serum Uric Acid Levels With Cardiovascular and All‐Cause Mortality in the Elderly: The Role of Malnourishment

The relationship between malnutrition risk and clinical outcomes in a cohort of frail older hospital patients

Relationship between mortality and Geriatric Nutritional Risk Index (GNRI) at the time of dialysis initiation: a prospective multicenter cohort study

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