Geriatric Nutritional Risk Index: a new index for evaluating at-risk elderly medical patients
Geriatric Nutritional Risk Index: a new index for evaluating at-risk elderly medical patients
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DOI：
10.1093/ajcn/82.4.777
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发表时间：
2005-10-01
影响因子：
7.1
通讯作者：
Aussel, C
中科院分区：
文献类型：
--
作者：
Bouillanne, O;Morineau, G;Aussel, C
背景：营养风险指数（NRI）可以识别营养不良风险患者及其相关的发病率和死亡率。然而，这一指数仍然是有限的老年患者，因为在建立他们的正常weight.Objective的困难：因此，我们取代了通常的重量在这个公式中的理想体重根据洛伦兹公式（WLo），创建一个新的指数称为老年营养风险指数（GNRI）。设计：首先，一项前瞻性研究纳入了181住院老年患者。评估营养状况[白蛋白、前白蛋白和体重指数（BMI）]和GNRI。GNRI与考虑并发症（褥疮或感染）和6个月死亡率的严重程度评分相关。第二，GNRI前瞻性地测量在2474例患者入院的老年康复护理单元在3-y periods.Results：严重程度评分与白蛋白和GNRI，但不与BMI或体重：WLo。死亡风险（比值比）和并发症风险分别为29（95% CI：5.2，161.4）和4.4（95% CI：1.3，14.9）主要营养相关风险（GNRI：< 82），6.6（95% CI：1.3，33.0），4.9（95% CI：1.9，12.5）中度营养相关风险（GNRI：82至< 92），低营养相关风险（GNRI：92至：598）为5.6（95%CI：1.2，26.6）和3.3（95%CI：1.4，8.0）。相应地，12.2%，31.4%，29.4%和27.0%的2474例患者有重大，中度，低，无营养相关的risks.Conclusion：GNRI是一个简单而准确的工具，用于预测住院老年患者的发病率和死亡率的风险，并应系统地记录入院。
Background: Patients at risk of malnutrition and related morbidity and mortality can be identified with the Nutritional Risk Index (NRI). However, this index remains limited for elderly patients because of difficulties in establishing their normal weight.Objective: Therefore, we replaced the usual weight in this formula by ideal weight according to the Lorentz formula (WLo), creating a new index called the Geriatric Nutritional Risk Index (GNRI).Design: First, a prospective study enrolled 181 hospitalized elderly patients. Nutritional status [albumin, prealbumin, and body mass index (BMI)] and GNRI were assessed. GNRI correlated with a severity score taking into account complications (bedsores or infections) and 6-mo mortality. Second, the GNRI was measured prospectively in 2474 patients admitted to a geriatric rehabilitation care unit over a 3-y period.Results: The severity score correlated with albumin and GNRI but not with BMI or weight:WLo. Risk of mortality (odds ratio) and risk of complications were, respectively, 29 (95% CI: 5.2, 161.4) and 4.4 (95% CI: 1.3,14.9) for major nutrition-related risk (GNRI: < 82), 6.6 (95% CI: 1.3, 33.0), 4.9 (95% CI: 1.9, 12.5) for moderate nutrition-related risk (GNRI: 82 to < 92), and 5.6 (95% CI: 1.2, 26.6) and 3.3 (95% CI: 1.4, 8.0) for a low nutrition-related risk (GNRI: 92 to:598). Accordingly, 12.2%, 31.4%, 29.4%, and 27.0% of the 2474 patients had major, moderate, low, and no nutrition-related risk, respectively.Conclusion: GNRI is a simple and accurate tool for predicting the risk of morbidity and mortality in hospitalized elderly patients and should be recorded systematically on admission.