Geriatric Nutritional Risk Index and overall-cause mortality prediction in institutionalised elderly: A 3-year survival analysis

Emanuele Cereda, Annunciata Zagami, Alfredo Vanotti, Silvano Piffer, Carlo Pedrolli

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Background & aims: A new tool, the Geriatric Nutritional Risk Index (GNRI), was recently proposed to predict short-term complications in elderly medical patients but no information is available when long-term follow-up periods are considered. Methods: A 3-year follow-up study in 245 institutionalised elderly (51 M:194 F; 83.7 ± 8.6 years). Nutritional risk was graded by GNRI (severe, 98). Main outcome was overall-cause death. Results: After the follow-up 99 (26 M:73 F) events occurred. Nutritional risk prevalence was 5.7%, 24.1%, 34.7% and 35.5% and mortality rates were 71.4%, 48.6% 33.7% and 34.3% with the GNRI <82, 82 to 98, respectively. Kaplan-Meier curves were significantly associated to GNRI (p = 0.0068). GNRI <82 was consistently related to death (odds ratio, OR = 5.29, [95%CI: 1.43-19.57], p = 0.0127) when compared to GNRI > 98. Similar results were confirmed by Cox regression (hazard ratio, HR = 2.76 [95%CI: 1.89-4.03], p = 0.0072). Finally, when "severe" and "moderate" risk were analysed as a single class (GNRI <92) outcome associations were: OR = 2.17, [95%CI: 1.10-4.28] (p = 0.0245); HR = 1.76 [95%CI: 1.34-2.23] (p = 0.0315). Survival analysis showed higher mortality rates by GNRI <92 (p = 0.0188). Conclusions: Present data support the use of the GNRI in the evaluation of long-term nutrition-related risk of death. We suggest a GNRI <92 as clinical trigger for nutritional support in institutionalised elderly.

Original languageEnglish
Pages (from-to)717-723
Number of pages7
JournalClinical Nutrition
Volume27
Issue number5
DOIs
Publication statusPublished - Oct 2008

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Nutrition Assessment
Survival Analysis
Geriatrics
Mortality
Nutritional Support
Cause of Death

Keywords

  • Albumin
  • Elderly
  • Geriatric Nutritional Risk Index (GNRI)
  • Long-term care
  • Mortality

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Nutrition and Dietetics

Cite this

Geriatric Nutritional Risk Index and overall-cause mortality prediction in institutionalised elderly : A 3-year survival analysis. / Cereda, Emanuele; Zagami, Annunciata; Vanotti, Alfredo; Piffer, Silvano; Pedrolli, Carlo.

In: Clinical Nutrition, Vol. 27, No. 5, 10.2008, p. 717-723.

Research output: Contribution to journalArticle

Cereda, Emanuele ; Zagami, Annunciata ; Vanotti, Alfredo ; Piffer, Silvano ; Pedrolli, Carlo. / Geriatric Nutritional Risk Index and overall-cause mortality prediction in institutionalised elderly : A 3-year survival analysis. In: Clinical Nutrition. 2008 ; Vol. 27, No. 5. pp. 717-723.
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T1 - Geriatric Nutritional Risk Index and overall-cause mortality prediction in institutionalised elderly

T2 - A 3-year survival analysis

AU - Cereda, Emanuele

AU - Zagami, Annunciata

AU - Vanotti, Alfredo

AU - Piffer, Silvano

AU - Pedrolli, Carlo

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N2 - Background & aims: A new tool, the Geriatric Nutritional Risk Index (GNRI), was recently proposed to predict short-term complications in elderly medical patients but no information is available when long-term follow-up periods are considered. Methods: A 3-year follow-up study in 245 institutionalised elderly (51 M:194 F; 83.7 ± 8.6 years). Nutritional risk was graded by GNRI (severe, 98). Main outcome was overall-cause death. Results: After the follow-up 99 (26 M:73 F) events occurred. Nutritional risk prevalence was 5.7%, 24.1%, 34.7% and 35.5% and mortality rates were 71.4%, 48.6% 33.7% and 34.3% with the GNRI <82, 82 to 98, respectively. Kaplan-Meier curves were significantly associated to GNRI (p = 0.0068). GNRI <82 was consistently related to death (odds ratio, OR = 5.29, [95%CI: 1.43-19.57], p = 0.0127) when compared to GNRI > 98. Similar results were confirmed by Cox regression (hazard ratio, HR = 2.76 [95%CI: 1.89-4.03], p = 0.0072). Finally, when "severe" and "moderate" risk were analysed as a single class (GNRI <92) outcome associations were: OR = 2.17, [95%CI: 1.10-4.28] (p = 0.0245); HR = 1.76 [95%CI: 1.34-2.23] (p = 0.0315). Survival analysis showed higher mortality rates by GNRI <92 (p = 0.0188). Conclusions: Present data support the use of the GNRI in the evaluation of long-term nutrition-related risk of death. We suggest a GNRI <92 as clinical trigger for nutritional support in institutionalised elderly.

AB - Background & aims: A new tool, the Geriatric Nutritional Risk Index (GNRI), was recently proposed to predict short-term complications in elderly medical patients but no information is available when long-term follow-up periods are considered. Methods: A 3-year follow-up study in 245 institutionalised elderly (51 M:194 F; 83.7 ± 8.6 years). Nutritional risk was graded by GNRI (severe, 98). Main outcome was overall-cause death. Results: After the follow-up 99 (26 M:73 F) events occurred. Nutritional risk prevalence was 5.7%, 24.1%, 34.7% and 35.5% and mortality rates were 71.4%, 48.6% 33.7% and 34.3% with the GNRI <82, 82 to 98, respectively. Kaplan-Meier curves were significantly associated to GNRI (p = 0.0068). GNRI <82 was consistently related to death (odds ratio, OR = 5.29, [95%CI: 1.43-19.57], p = 0.0127) when compared to GNRI > 98. Similar results were confirmed by Cox regression (hazard ratio, HR = 2.76 [95%CI: 1.89-4.03], p = 0.0072). Finally, when "severe" and "moderate" risk were analysed as a single class (GNRI <92) outcome associations were: OR = 2.17, [95%CI: 1.10-4.28] (p = 0.0245); HR = 1.76 [95%CI: 1.34-2.23] (p = 0.0315). Survival analysis showed higher mortality rates by GNRI <92 (p = 0.0188). Conclusions: Present data support the use of the GNRI in the evaluation of long-term nutrition-related risk of death. We suggest a GNRI <92 as clinical trigger for nutritional support in institutionalised elderly.

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