title: Nutritional screening and mortality in newly institutionalised elderly: a comparison between the geriatric nutritional risk index and the mini nutritional assessment.
abstract: OBJECTIVE
  Several tools are available for nutritional screening. We evaluated the risk of mortality associated with the Geriatric Nutritional Risk Index (GNRI) and the Mini Nutritional Assessment (MNA) in newly institutionalised elderly.
  
  
  METHODS
  A prospective observational study involving 358 elderly newly admitted to a long-term care setting. Hazard ratios (HR) for mortality among GNRI categories and MNA classes were estimated by multivariable Cox's model.
  
  
  RESULTS
  At baseline, 32.4% and 37.4% of the patients were classified as being malnourished (MNA <17) and at severe nutritional risk (GNRI <92), respectively, whereas 57.5% and 35.2%, respectively, were classified as being at risk for malnutrition (MNA 17-23.5) and having low nutritional risk (GNRI 92-98). During a median follow-up of 6.5 years [25th-75th percentile, 5.9-8.6], 297 elderly died. Risk for all-cause mortality was significantly associated with nutritional risk by the GNRI tool (GNRI<92 HR = 1.99 [95%CI, 1.38-2.88]; GNRI 92-98 HR = 1.51 [95%CI, 1.04-2.18]) but not with nutritional status by the MNA. A significant association was also found with cardiovascular mortality (GNRI <92 HR = 1.79 [95%CI, 1.23-2.61]).
  
  
  CONCLUSIONS
  Nutritional risk by GNRI but not nutritional status by MNA was associated with higher mortality risk. Present data suggest that in the nutritional screening of newly institutionalised elderly the use of the GNRI should be preferred to that of the MNA.
authors: Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100 Pavia, Italy. e.cereda@smatteo.pv.it
authors: Emanuele
authors: E
authors: Cereda
authors: Carlo
authors: C
authors: Pedrolli
authors: Annunciata
authors: A
authors: Zagami
authors: Alfredo
authors: A
authors: Vanotti
authors: Silvano
authors: S
authors: Piffer
authors: Annalisa
authors: A
authors: Opizzi
authors: Mariangela
authors: M
authors: Rondanelli
authors: Riccardo
authors: R
authors: Caccialanza
mesh_terms: D000368:Aged; D000886:Anthropometry; D019540:Area Under Curve; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D015577:Geriatric Assessment / Q000379:methods*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007558:Italy; D008134:Long-Term Care; D018655:Lymphocyte Count; D044342:Malnutrition / Q000175:diagnosis*; D015596:Nutrition Assessment; D011228:Prealbumin / Q000378:metabolism; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012372:ROC Curve; D012709:Serum Albumin / Q000378:metabolism; D015996:Survival Rate; D014168:Transferrin / Q000378:metabolism
chemical_list: D006454:Hemoglobins; D011228:Prealbumin; D012709:Serum Albumin; D014168:Transferrin; D002784:Cholesterol; D003404:Creatinine