Geriatric Nutritional Risk Index: a new index for evaluating at-risk elderly medical patients

Bouillanne, O.; Morineau, Gilles; Dupont, Claire; Coulombel, Isabelle; Vincent, Jean‐Pierre; Nicolis, Ioannis; Bénazeth, S.; Cynober, Luc; Aussel, Christian

doi:10.1093/ajcn/82.4.777

Cited by 1,477 publications

(1,569 citation statements)

References 27 publications

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“…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%

“…The ideal weight was calculated by the Lorentz formula 26. Furthermore, a body mass index (BMI) of 22 kg/m 2 is associated with the lowest morbidity in Asians 28.…”

Section: Methodsmentioning

confidence: 99%

“…The mildly malnourished groups were defined as those having either a GNRI ≥82 but <98, a serum albumin level ≥30 but <38 g/L, or a BMI ≥19 but <22 kg/m 2 . The severely malnourished groups were defined as those having either a GNRI <82, a serum albumin level <30 g/L, or a BMI <19 kg/m 2 26. Estimated glomerular filtration rate (eGFR) was calculated by the Chronic Kidney Disease Epidemiology Collaboration equation 29…”

Section: Methodsmentioning

confidence: 99%

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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

119

100

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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: Methodsmentioning

confidence: 99%

“…The ideal weight was calculated by the Lorentz formula 26. Furthermore, a body mass index (BMI) of 22 kg/m 2 is associated with the lowest morbidity in Asians 28.…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

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

119

100

View full text Add to dashboard Cite

show abstract

“…The GNRI was calculated from the patient's serum albumin and body weight by using the equation developed Ideal weight in this study was calculated from the Lorentz equations for men and women differently, as in the original GNRI equation (4). Recently, GNRI ,90 was demonstrated as an indicator of poor nutritional status and as a significant predictor of mortality in 490 Japanese chronic hemodialysis patients (11).…”

Section: Gnrimentioning

confidence: 99%

Comparison Analysis of Nutritional Scores for Serial Monitoring of Nutritional Status in Hemodialysis Patients

Beberashvili

Azar

Sinuani

et al. 2013

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives This study aimed to compare the longitudinal performance of the malnutritioninflammation score (MIS) and the geriatric nutritional risk index (GNRI), two nutritional scores for patients on maintenance hemodialysis.Design, setting, participants, & measurements Nutritional scores, dietary intake, biochemical markers, and body composition analysis were performed at baseline and at 6, 12, and 18 months after enrollment (which took place from January through December 2006) on 75 prevalent hemodialysis patients (43% women, mean age 64.8611.9 years). The patients underwent simultaneous MIS and GNRI assessments calculated by two independent examiners from baseline. The study period was 46.8616.4 months.Results GNRI had higher interobserver agreement (weighted k-score 0.98) than MIS (weighted k-score 0.62). Longitudinally, a 1-unit increase in MIS was associated with a 0.41 kcal/kg per day reduction in daily energy intake (P,0.001) and with a 0.014 g/kg per day reduction in nPNA (P=0.02). GNRI did not correlate with the change over time of dietary intake. Longitudinal changes of both scores were associated with appropriate changes over time in levels of nutritional biomarkers, inflammation (IL-6), and body composition parameters. Both scores expressed significant associations with prospective hospitalization, whereas only MIS was associated with mortality in this cohort. The multivariate Cox proportional hazard ratio was 1.15 for death for each 1-unit increase in the MIS (95% confidence interval, 1.03-1.3; P=0.02).Conclusions Both MIS and GNRI are valid tools for longitudinal assessment of hemodialysis patients' nutritional status. MIS has lower interobserver reproducibility than GNRI; however, MIS is more comprehensive than GNRI.

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“…Laboratory values which indicate nutritional insufficiency may be used as a screening tool for preoperative nutritional status [2,6,9,18]. The determination of the most appropriate tests in specific patients is poorly defined [19][20][21][22][23][24][25][26]. Serum albumin, total lymphocyte count and serum transferrin are commonly used to define nutritional status.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Malnutrition on Patients Undergoing Elective Joint Arthroplasty

Huang

Greenky

Kerr

et al. 2013

The Journal of Arthroplasty

159

141

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Geriatric Nutritional Risk Index: a new index for evaluating at-risk elderly medical patients

Abstract: GNRI is a simple and accurate tool for predicting the risk of morbidity and mortality in hospitalized elderly patients and should be recorded systematically on admission.

Cited by 1,477 publications

References 27 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

Comparison Analysis of Nutritional Scores for Serial Monitoring of Nutritional Status in Hemodialysis Patients

The Effect of Malnutrition on Patients Undergoing Elective Joint Arthroplasty

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