The prognostic value of geriatric nutritional risk index in elderly patients with severe community-acquired pneumonia

Abstract

The geriatric nutritional risk index (GNRI) is associated with the prognosis of many diseases. However, the association between the GNRI and the prognosis of patients aged ≥65 years with severe community-acquired pneumonia (SCAP) has not been studied. We aimed to evaluate the prognostic value of GNRI in elderly SCAP patients. This study retrospectively analyzed the clinical data of 346 patients aged ≥65 years with SCAP from December 2013 to September 2019. Patients were divided into 4 groups by the GNRI. The chi-square test or student's t test was used to compare the differences between the groups. Logistic regression analysis was used to evaluate the factors that affect prognosis. The receiver operating characteristic curve was used to compare the prognostic performance of the GNRI with other indicators. A GNRI-based nomogram was established based on the result of the multivariate analysis. Two hundred nine (60.4%) patients had a poor prognosis. GNRI scores were significantly lower in the poor prognosis group than in the group with a good prognosis. In the multivariate analysis, gender, mean arterial pressure, neutrophil counts, and the GNRI were independently correlated with the prognosis of elderly patients. The GNRI was a significantly better predictor for poor prognosis than other indicators. The GNRI-based nomogram had excellent prediction capabilities. GNRI is a simple and effective prognostic indicator for elderly patients with SCAP, and a GNRI-based nomogram can aid in developing individualized treatment plans for elderly patients with SCAP.

Effects of fluid and drinking on pneumonia mortality in older adults: A systematic review and meta-analysis

“…Six were conducted in Asia, seven each in Europe and North America, and one included people from multiple continents [ 48 ]. Twelve cohorts included people with CAP [ [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] ], one with HAP [ 60 ], none with COVID-19 pneumonia, one with AP [ [61] , [62] , [63] ], three with HCAP or NHCAP [ [64] , [65] , [66] ], five described “pneumonia” only, or included mixed types of pneumonias [ 47 , [67] , [68] , [69] , [70] ]. One of these cohorts published data on two sub-cohorts, one of people with CAP, the other with pneumonia and chronic kidney disease [ 70 ].…”

“…In 346 older people (mean age 78 years) hospitalised with NHCAP in China, the odds of poor prognosis (death in hospital or automatic discharge due to adverse prognosis) were greater in those with higher BUN (OR 1.06, 95% CI 1.02 to 1.09) in univariate analysis, but not significant in multivariate analysis [ 59 ].…”

Prognostic value of geriatric nutritional risk index for aspiration pneumonia: a retrospective study

“…16 Wei et al reported that GNRI demonstrated superior predictive value for poor prognosis compared with other inflammatory indicators in older patients with severe community-acquired pneumonia (CAP). 17 Nevertheless, the prognostic utility of GNRI in older patients with aspiration pneumonia remains unclear. Therefore, this study aimed to investigate the prognostic utility of GNRI in older patients with aspiration pneumonia.…”

Adherence to National Antimicrobial Guidelines in Hospitalized Geriatric Patients with Community-Acquired Pneumonia: A Prospective Observational study in a Malaysian Hospital

“…The most effective recommendations for the care of CAP patients are vaccination and case management, according to the World Health Organization (WHO) [ 7 ]. These have been demonstrated to reduce mortality and morbidity, thereby reducing hospital stays [ 7 , 8 ]. Several studies have found that following treatment guidelines and adhering to them reduces morbidity, death, and healthcare expenditures [ 8 , 9 ].…”

“…These have been demonstrated to reduce mortality and morbidity, thereby reducing hospital stays [ 7 , 8 ]. Several studies have found that following treatment guidelines and adhering to them reduces morbidity, death, and healthcare expenditures [ 8 , 9 ]. Although guidelines can steer and standardize illness care, their influence on disease outcomes is less quantifiable.…”