title: The validity of Geriatric Nutrition Risk Index: simple tool for prediction of nutritional-related complication of hospitalized elderly patients. Comparison with Mini Nutritional Assessment.
abstract: OBJECTIVE
  The Geriatric Nutritional Risk Index (GNRI) is a promising tool initially proposed to predict nutrition-related complications in sub-acute care setting. So, the main aim of this study was to validate the use of GNRI in hospitalized elderly patients by testing its ability to predict patients' outcome through the comparison with Mini Nutritional Assessment (MNA).
  
  
  METHODS
  A prospective cohort study was conducted on 131 patients aged 60 and over admitted consecutively from October 2011 to September 2012 to the acute geriatrics medical ward in Ain Shams University hospitals, Cairo, Egypt. All patients were subjected to nutritional screening using GNRI and MNA and measurement of weight, body mass index (BMI), mid arm circumference (MAC), and calf circumference (CC), serum levels of total protein, albumin and prealbumin. Patients were followed for 6 months for the occurrence of major health complications as prolonged length of stay, infectious complications and mortality.
  
  
  RESULTS
  Mean age was 69.32 ± 8.17 years. Lower GNRI scores were statically significantly associated with worse MNA scores, lower weight, BMI, MAC, CC and albumin (P value < 0.001 for all). Only with GNRI, increasing odds ratio (OR) was seen with increasing risk of nutrition-related complication (from mild to moderate to severe). ORs (95%CI) for three month mortality were 1.63(0.0.27-10.00), 5.03(1.36-18.52), and 11.24(3.03-41.67), and OR (95%CI) for six month mortality were 1.64(0.403-6.62), 4.29 (1.45-12.66), and 5.71(1.87-17.54) respectively compared to patients with no risk and. By regression, both severe and moderate grade of GNRI were independent predictors of three and six month mortality (P value for three month: 0.002, 0.015; for six month: 0.002, 0.008 respectively) after adjustment of age, sex, and cancer rather than MNA.
  
  
  CONCLUSIONS
  GNRI showed a higher prognostic value for describing and classification of nutritional status and nutritional-related complications in hospitalized elderly patients in addition to its simplicity.
authors.affiliation: Geriatrics and Gerontology Department, Faculty of Medicine, Ain Shams University, Abbassia, Cairo, Egypt. Electronic address: wafaager@hotmail.com.
authors.forename: Wafaa Mostafa
authors.initials: WM
authors.lastname: Abd-El-Gawad
authors.affiliation: Geriatrics and Gerontology Department, Faculty of Medicine, Ain Shams University, Abbassia, Cairo, Egypt. Electronic address: rania_geriatric@yahoo.com.
authors.forename: Rania Mohammed
authors.initials: RM
authors.lastname: Abou-Hashem
authors.affiliation: Clinical Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Electronic address: maraghy@yahoo.com.
authors.forename: Mohamed Omar
authors.initials: MO
authors.lastname: El Maraghy
authors.affiliation: Environmental and Occupational Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Electronic address: ghadaessam95@yahoo.com.
authors.forename: Ghada Essam
authors.initials: GE
authors.lastname: Amin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D001835:Body Weight; D004534:Egypt / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D044342:Malnutrition / Q000175:diagnosis*; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D011228:Prealbumin / Q000378:metabolism; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D015203:Reproducibility of Results; D018570:Risk Assessment; D012709:Serum Albumin / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D011228:Prealbumin; D012709:Serum Albumin
keywords: GNRI; Hospitalized elderly; MNA; Mortality