title: Performance of the Geriatric Nutritional Risk Index in predicting 28-day hospital mortality in older adult patients with sepsis.
abstract: OBJECTIVE
  The Geriatric Nutritional Risk Index (GNRI) is a screening tool for nutrition-related risk that correlates with mortality rate in hospitalized older patients and is simple, objective, and readily available to clinicians. In this study, we aimed to validate the performance of the GNRI in predicting short-term hospital mortality in older patients with sepsis.
  
  
  METHODS
  This observational study enrolled 401 older patients presenting with infection and systemic inflammatory response syndrome in an emergency department. Demographic, physiological, and laboratory data were collected. The GNRI score was categorized into five classes. The primary outcome was 28-day hospital mortality. Univariate and multivariate analyses were performed to identify clinical predictors of outcome. A logistic regression model was used.
  
  
  RESULTS
  51 patients (12.7%) died in the hospital within 28 days. Co-morbid metastatic cancer, heart rate, respiratory rate, temperature, serum creatinine, total lymphocyte count, and GNRI (<87) were independently related to the outcome in the multivariable logistic regression analysis.
  
  
  CONCLUSIONS
  The GNRI is a prognostic factor for short-term hospital mortality in older patients with sepsis. A GNRI below 87 can be suggested as an indicator of nutritional support need in an acute-care setting.
authors: Department of Emergency Medicine, School of Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 130-701, South Korea.
authors: Jong Seok
authors: JS
authors: Lee
authors: Han Sung
authors: HS
authors: Choi
authors: Young Gwan
authors: YG
authors: Ko
authors: Dong Hwan
authors: DH
authors: Yun
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D004636:Emergency Service, Hospital; D005260:Female; D015577:Geriatric Assessment; D017052:Hospital Mortality; D006784:Hospitals, Teaching; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D015596:Nutrition Assessment; D011379:Prognosis; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D012720:Severity of Illness Index; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy
keywords: AUC; CI; ED; GNRI; Geriatric Nutritional Risk Index; Geriatrics; Hospital mortality; ICU; IQR; Infection; MEDS; Malnutrition; Mortality in Emergency Department Sepsis; OR; PaCO(2); ROC; SD; SIRS; SOFA; Screening; Sepsis-related Organ Failure Assessment; VIF; area under the curve; confidence interval; emergency department; intensive care unit; interquartile range; odds ratio; partial pressure of arterial carbon dioxide; receiver operating characteristic; standard deviation; systemic inflammatory response syndrome; variance inflation factor