title: Geriatric nutritional risk index correlates with length of hospital stay and inflammatory markers in older inpatients.
abstract: Malnutrition is a prevalent condition in older inpatients and has been shown to increase morbidity and direct medical costs. A number of established tools to assess malnutrition are available but malnourished patients rarely receive adequate nutritional assessment and treatment. The medical and economic consequences of malnutrition in hospitalized patients are therefore often underestimated. This study investigates whether the Geriatric Nutritional Risk Index (GNRI) predicts hospital mortality, correlates with length of hospital stay (LOS) and inflammatory markers in older inpatients.
  
  
  
  We conducted a prospective monocentric study in 500 hospital patients over 65 years of age (female: 248; male: 252; age: 76.3 ± 0.31 years). GNRI was correlated to C-reactive protein (CRP), lymphocyte count, LOS and all-cause mortality, adjusted for potential confounders.
  
  
  
  The median body mass index was 24.1 (25th percentile: 21.1; 75th percentile: 27.8) kg/m2and the mean GNRI 82.2 ± 0.56. A higher risk GNRI was associated with increased CRP levels (p < 0.05) and low lymphocyte counts (p < 0.05) after multivariable adjustment. Moreover, we found positive correlation between a higher risk GNRI and length of hospital stay, whereas, the association with in-hospital mortality was not significant.
  
  
  
  The GNRI correlates well with indicators of inflammation and the length of hospital stay. The routine implementation of the GNRI for the nutritional assessment of older patients could have a significant medical and socio-economic impact.
authors.affiliation: Department of Internal Medicine A, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany. Electronic address: simone.gaertner@uni-greifswald.de.
authors.forename: Simone
authors.initials: S
authors.lastname: Gärtner
authors.affiliation: Department of Internal Medicine A, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany. Electronic address: m.kraft@vinzentius.de.
authors.forename: Matthias
authors.initials: M
authors.lastname: Kraft
authors.affiliation: Department of Internal Medicine A, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany. Electronic address: janine.krueger@uni-greifswald.de.
authors.forename: Janine
authors.initials: J
authors.lastname: Krüger
authors.affiliation: Department of Internal Medicine A, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany. Electronic address: lena.vogt@uni-greifswald.de.
authors.forename: Lena J
authors.initials: LJ
authors.lastname: Vogt
authors.affiliation: Department of Internal Medicine A, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany. Electronic address: michael.fiene@uni-greifswald.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Fiene
authors.affiliation: Department of Internal Medicine A, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany. Electronic address: julia.mayerle@uni-greifswald.de.
authors.forename: Julia
authors.initials: J
authors.lastname: Mayerle
authors.affiliation: Department of Internal Medicine A, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany. Electronic address: aghdassi@uni-greifswald.de.
authors.forename: Ali A
authors.initials: AA
authors.lastname: Aghdassi
authors.affiliation: Department of Internal Medicine A, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany. Electronic address: antje.steveling@uni-greifswald.de.
authors.forename: Antje
authors.initials: A
authors.lastname: Steveling
authors.affiliation: Institute for Community Medicine, Walter-Rathenau-Str. 48, 17475, Greifswald, Germany. Electronic address: voelzke@uni-greifswald.de.
authors.forename: Henry
authors.initials: H
authors.lastname: Völzke
authors.affiliation: Institute for Community Medicine, Walter-Rathenau-Str. 48, 17475, Greifswald, Germany. Electronic address: sebastian.baumeister@klinik.uni-regensburg.de.
authors.forename: Sebastian E
authors.initials: SE
authors.lastname: Baumeister
authors.affiliation: Department of Internal Medicine A, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany. Electronic address: lerch@uni-greifswald.de.
authors.forename: Markus M
authors.initials: MM
authors.lastname: Lerch
authors.affiliation: Department of Internal Medicine A, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany. Electronic address: peter.simon@uni-greifswald.de.
authors.forename: Peter
authors.initials: P
authors.lastname: Simon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D015331:Cohort Studies; D058620:Elder Nutritional Physiological Phenomena; D005260:Female; D015577:Geriatric Assessment; D005858:Germany / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D007902:Length of Stay; D018655:Lymphocyte Count; D008297:Male; D044342:Malnutrition / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D015596:Nutrition Assessment; D009752:Nutritional Status; D011446:Prospective Studies; D012306:Risk; D012720:Severity of Illness Index; D062606:Tertiary Care Centers
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators
keywords: GNRI; Hospital mortality; Inflammatory markers; Length of stay