Geriatric Nutritional Risk Index has a Prognostic value for Recovery Outcomes in Elderly Patients with Brain Abscess

Abstract

Background: The Geriatric Nutritional Risk Index (GNRI) is a straightforward and objective tool for nutritional screening in elderly patients and has been demonstrated to possess prognostic predictive value in several diseases. Nonetheless, there is a lack of research on the nutritional risk associated with brain abscess in the elderly. This study aimed to evaluate the prevalence of nutritional risk among these patients by GNRI and to investigate its potential prognostic value for clinical outcomes. Methods: From August 2019 to April 2023, 100 elderly patients diagnosed with brain abscess were enrolled in the study. The collected data encompassed age, gender, body mass index (BMI), smoking and alcohol consumption history, number of comorbidities, length of hospital stay (LOS), serum albumin and C-reactive protein (CRP) levels at admission and calculated the GNRI, the Glasgow outcome scale (GOS) score 6 months post-discharge. A GOS score of 5 was considered indicative of a good recovery, whereas scores ranging from 1 to 4 were classified as poor recovery. Results: The prevalence of malnutrition risk among elderly patients with brain abscesses was found to be 48% according to GNRI. Compared to those without nutritional risk, patients at risk exhibited significantly higher post-admission C-reactive protein (CRP) levels (P=0.017), a greater number of comorbidities (P<0.001), and elevated age-adjusted Charlson Comorbidity Index (aCCI) scores (P<0.001). Spearman correlation analysis revealed a negative correlation between GNRI scores and CRP levels, the number of comorbidities, and aCCI scores (Spearman's ρ=-0.291, -0.284, and -0.310, respectively), and a positive correlation with Glasgow Outcome Scale (GOS) scores (Spearman's ρ=0.624, P<0.001). Multivariate logistic regression analysis indicated that lower GNRI values in these patients were associated with reduced GOS levels (OR = 0.826, 95% CI: 0.775-0.880). Furthermore, receiver operating characteristic (ROC) analysis identified a GNRI threshold of 97.50 for predicting poor recovery, with a sensitivity of 90.57% and a specificity of 87.23%. Conclusions: Elderly brain abscess patients exhibited a high malnutrition risk. GNRI showed an important predictive value for recovery in elderly patients, which could be helpful in clinical intervention and rehabilitation.