The prognostic effects of the geriatric nutritional risk index on elderly acute kidney injury patients in intensive care units

Abstract

IntroductionThe geriatric nutritional risk index (GNRI), a nutritional screening tool specifically for the aging population, has been proven to be associated with worse outcomes in chronic kidney disease patients, especially in the hemodialysis population. However, the predictive validity of GNRI in critically ill elderly patients with acute kidney injury (AKI) is yet to be determined. This analysis sought to examine the prognostic effects of GNRI on elderly AKI patients in intensive care units (ICUs).MethodsWe collected elderly AKI patient-relevant data from the Medical Information Mart for Intensive Care III database. AKI was diagnosed and staged according to the “Kidney Disease Improving Global Outcomes” criteria. In the study, 1-year mortality was considered the primary outcome, whereas in-hospital, ICU, 28-day and 90-day mortality, and prolonged length of stay in ICU and hospital were selected as the secondary outcomes.ResultsIn all, 3,501 elderly patients with AKI were selected for this study, with a 1-year mortality rate of 36.4%. We classified the study population into low (≤98) and high (>98) GNRI groups based on the best cutoff value. The incidence of endpoints was remarkably lower in patients with elevated GNRI (p < 0.001). When stratified by the AKI stage, patients with high GNRI at AKI stages 1, 2, and 3 had markedly lower 1-year mortality than those with low GNRI (all p < 0.05). The multivariable regression analysis identified the independent prognostic ability of GNRI on the research outcomes (all p < 0.05). Restricted cubic spline exhibited a linear correlation between GNRI and 1-year death (p for non-linearity = 0.434). The prognostic implication of GNRI on 1-year mortality was still significant in patients with the most subgroups.ConclusionIn critically ill elderly patients with AKI, elevated GNRI upon admission was strongly correlated with a lower risk of unfavorable outcomes.

The Geriatric Nutritional Risk Index is related to adverse hospitalization outcomes in individuals undergoing cardiac surgery

“…Furthermore, individuals at a higher risk of malnutrition experienced signi cantly prolonged hospitalization and CICU stays. Subsequent studies have rea rmed this association, establishing a link between GNRI, extended hospital stays, and adverse outcomes 30 . Despite its established association in various settings, the prognostic value of GNRI in cardiac surgery has received limited attention in prior research.…”

Association between geriatric nutritional risk index and 28 days mortality in elderly patients with sepsis: a retrospective cohort study

“…However, the lack of a significant relationship between GNRI and ICU LOS could potentially be attributed to the relatively short average duration of ICU stay, which was 4.9 days. Prior studies (21)(22)(23)(24) have explored the prognostic significance of GNRI in specific ICU populations. However, the optimal GNRI cutoff values for elderly septic patients as a whole remain unclear.…”

“…Many countries are currently experiencing the phenomenon of aging societies, characterized by a significant increase in the elderly population (≥80 years), resulting in a consequent rise in ICU admissions of elderly patients ( 20 ). While previous studies have explored the association between GNRI and elderly patients with acute kidney injury ( 21 ), multiple organ dysfunction syndromes ( 22 ), acute respiratory failure ( 23 ), and trauma ( 24 ), our study is the first to examine the relationship between GNRI and the prognosis of elderly septic patients in ICU. Elderly patients suffering from sepsis face elevated mortality rates, often exacerbated by diagnostic delays attributed to the complexities of their conditions ( 25 ).…”