Determining the optimal value of the Geriatric Nutritional Risk Index to screen older patients with malnutrition risk: A study at a university hospital in Japan

Abstract

Aim The Geriatric Nutritional Risk Index (GNRI) can predict nutritional risk. However, just a few studies have validated the optimal cut‐off value of GNRI for nutrition screening in older patients. Hence, this study aimed to determine the optimal value of GNRI to screen the risk of malnutrition among older patients. Methods This retrospective cross‐sectional study was carried out with 5867 consecutive older adult patients who were admitted to an academic hospital in Japan. Receiver operating characteristic curve analyses were carried out to obtain the optimal cut‐off value of GNRI, and the results were compared against the Mini Nutritional Assessment – Short Form and Malnutrition Universal Screening Tool. The validation of the obtained cut‐off value was examined on the concordance rate of malnutrition diagnosis based on the European Society of Clinical Nutrition and Metabolism criteria. Results The mean age of the patients was 76.0 ± 7.0 years. The optimal cut‐off value of GNRI for Mini Nutritional Assessment – Short Form ≤11 points was 95.92 (area under the curve 0.827 [0.817–0.838], P < 0.001), and that for Malnutrition Universal Screening Tool ≥1 point was 95.95 (area under the curve 0.788 [0.776–0.799], P < 0.001). By adapting GNRI <96 points as an initial screening cut‐off in the European Society of Clinical Nutrition and Metabolism‐defined malnutrition process, the concordance rates of comparisons were 98.5% and 98.5% for Mini Nutritional Assessment – Short Form‐based and MUST‐based diagnosis, respectively. Conclusions The study showed GNRI <96 points as the optimal cut‐off value for nutritional screening. GNRI might be one of the easy‐to‐use tools for nutritional screening and for diagnosing malnutrition in older adults. Geriatr Gerontol Int 2020; 20: 811–816.

The Geriatric Nutritional Risk Index Is an Optimal Evaluation Parameter for Predicting Mortality in Adult All Ages Hemodialysis Patients: A Korean Population-Based Study

“…They reported a GNRI cutoff value < 91.2 as the most accurate for identifying malnourished patients, according to the MIS. Another study at a university hospital reported an optimal cutoff GNRI value of < 96 for nutritional screening among older patients [19]. The suggested GNRI values for identifying malnutrition may differ between various clinical settings.…”

“…To identify the GNRI cutoff value for mortality prediction, we calculated Harrell's C-index of GNRI in the multivariate Cox regression model (Model 3) [19]. The highest value of C-index was identified as the cutoff value of GNRI for all-cause mortality in this population.…”