Department of Emergency Medicine, School of Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 130-701, South Korea.
Clin Nutr. 2013 Oct;32(5):843-8. doi: 10.1016/j.clnu.2013.01.007. Epub 2013 Jan 23.
BACKGROUND & AIMS: The Geriatric Nutritional Risk Index (GNRI) is a screening tool for nutrition-related risk that correlates with mortality rate in hospitalized older patients and is simple, objective, and readily available to clinicians. In this study, we aimed to validate the performance of the GNRI in predicting short-term hospital mortality in older patients with sepsis.
This observational study enrolled 401 older patients presenting with infection and systemic inflammatory response syndrome in an emergency department. Demographic, physiological, and laboratory data were collected. The GNRI score was categorized into five classes. The primary outcome was 28-day hospital mortality. Univariate and multivariate analyses were performed to identify clinical predictors of outcome. A logistic regression model was used.
51 patients (12.7%) died in the hospital within 28 days. Co-morbid metastatic cancer, heart rate, respiratory rate, temperature, serum creatinine, total lymphocyte count, and GNRI (<87) were independently related to the outcome in the multivariable logistic regression analysis.
The GNRI is a prognostic factor for short-term hospital mortality in older patients with sepsis. A GNRI below 87 can be suggested as an indicator of nutritional support need in an acute-care setting.
老年营养风险指数(GNRI)是一种与住院老年患者死亡率相关的营养相关风险筛查工具,其具有简单、客观和易于临床医生使用的特点。本研究旨在验证 GNRI 在预测老年脓毒症患者短期住院死亡率方面的性能。
本观察性研究纳入了急诊科就诊的感染和全身炎症反应综合征的 401 例老年患者。收集了人口统计学、生理学和实验室数据。GNRI 评分分为五组。主要结局为 28 天住院死亡率。进行了单因素和多因素分析,以确定预后的临床预测因素。使用逻辑回归模型。
28 天内有 51 例(12.7%)患者在医院死亡。合并转移性癌症、心率、呼吸频率、体温、血清肌酐、总淋巴细胞计数和 GNRI(<87)在多变量逻辑回归分析中与结局独立相关。
GNRI 是老年脓毒症患者短期住院死亡率的预后因素。GNRI 低于 87 可提示在急性护理环境中需要营养支持。