title: The Geriatric Nutritional Risk Index predicts hospital length of stay and in-hospital weight loss in elderly patients.
abstract: OBJECTIVE
  Nutritional derangements are common in elderly patients, but how nutritional risk affects outcome in this subset of hospital inpatients deserves further investigation. We evaluated the impact of nutritional risk on length of stay (LOS) and in-hospital weight loss (WL) in elderly patients (>65 yrs).
  
  
  METHODS
  Nutritional risk was assessed by the Geriatric Nutritional Risk Index (GNRI) in a prospective multicentre hospital-based cohort study. The outcomes were LOS and in-hospital WL.
  
  
  RESULTS
  In the whole sample (N = 667), the prevalence of high (GNRI < 92) and mild (GNRI: 92-98) nutritional risk were 33% and 25%, respectively. Patients with a high nutritional risk were more likely (OR = 1.89; 95%CI: 1.22-2.92) to stay longer in hospital (fourth quartile, LOS ≥ 20 days) compared to those without. Other factors associated with prolonged LOS were cancer diagnosis (OR = 2.52; 95%CI: 1.69-3.75), the presence of comorbidities (OR = 1.24; 95%CI: 1.11-1.40) and surgical setting (OR = 1.65; 95%CI: 1.10-2.47). In-hospital WL ≥ 5% was recorded in 75 ambulant patients from a representative subgroup (N = 583). It was independently associated with prolonged LOS (OR = 1.80; 95%CI: 1.03-3.06) and was more frequent among cancer patients (OR = 1.88; 95%CI: 1.09-3.24), in patients with a high nutritional risk (OR = 2.23; 95%CI: 1.20-4.14) or those admitted to surgical units (OR = 1.77; 95%CI: 1.02-3.05).
  
  
  CONCLUSIONS
  Nutritional risk assessed by the GNRI on admission, predicts LOS and in-hospital WL in elderly patients.
authors: Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. Electronic address: e.cereda@smatteo.pv.it.
authors: Emanuele
authors: E
authors: Cereda
authors: Biometry and Statistics Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors: Catherine
authors: C
authors: Klersy
authors: Dietetic and Clinical Nutrition Unit, Trento Hospital, Trento, Italy.
authors: Carlo
authors: C
authors: Pedrolli
authors: Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors: Barbara
authors: B
authors: Cameletti
authors: Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors: Chiara
authors: C
authors: Bonardi
authors: Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors: Lara
authors: L
authors: Quarleri
authors: Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors: Silvia
authors: S
authors: Cappello
authors: Hospital Management Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors: Alberto
authors: A
authors: Bonoldi
authors: Medical Direction, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors: Elisa
authors: E
authors: Bonadeo
authors: Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors: Riccardo
authors: R
authors: Caccialanza
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status / Q000502:physiology*; D018529:Nutritional Support; D011446:Prospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D012720:Severity of Illness Index; D015431:Weight Loss
chemical_list: D012709:Serum Albumin
keywords: Elderly patients; Geriatric Nutritional Risk Index (GNRI); In-hospital weight loss; Length of stay; Nutritional assessment