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Association between Geriatric Nutritional Risk Index and Mortality in Older Trauma Patients in the Intensive Care Unit

The geriatric nutritional risk index (GNRI) is a simple and efficient tool to assess the nutritional status of patients with malignancies or after surgery. Because trauma patients constitute a specific population that generally acquires accidental and acute injury, this study aimed to identify the a...

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Autores principales: Liu, Hang-Tsung, Wu, Shao-Chun, Tsai, Ching-Hua, Li, Chi, Chou, Sheng-En, Su, Wei-Ti, Hsu, Shiun-Yuan, Hsieh, Ching-Hua
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7766904/
https://www.ncbi.nlm.nih.gov/pubmed/33348716
http://dx.doi.org/10.3390/nu12123861
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author Liu, Hang-Tsung
Wu, Shao-Chun
Tsai, Ching-Hua
Li, Chi
Chou, Sheng-En
Su, Wei-Ti
Hsu, Shiun-Yuan
Hsieh, Ching-Hua
author_facet Liu, Hang-Tsung
Wu, Shao-Chun
Tsai, Ching-Hua
Li, Chi
Chou, Sheng-En
Su, Wei-Ti
Hsu, Shiun-Yuan
Hsieh, Ching-Hua
author_sort Liu, Hang-Tsung
collection PubMed
description The geriatric nutritional risk index (GNRI) is a simple and efficient tool to assess the nutritional status of patients with malignancies or after surgery. Because trauma patients constitute a specific population that generally acquires accidental and acute injury, this study aimed to identify the association between the GNRI at admission and mortality outcomes of older trauma patients in the intensive care unit (ICU). Methods: The study population included 700 older trauma patients admitted to the ICU between 1 January 2009 and 31 December 2019. The collected data included age, sex, body mass index (BMI), albumin level at admission, preexisting comorbidities, injury severity score (ISS), and in-hospital mortality. Multivariate logistic regression analysis was conducted to identify the independent effects of univariate predictive variables resulting in mortality in our study population. The study population was categorized into four nutritional risk groups: a major-risk group (GNRI < 82; n = 128), moderate-risk group (GNRI 82 to <92; n = 191), low-risk group (GNRI 92–98; n = 136), and no-risk group (GNRI > 98; n = 245). Results: There was no significant difference in sex predominance, age, and BMI between the mortality (n = 125) and survival (n = 575) groups. The GNRI was significantly lower in the mortality group than in the survival group (89.8 ± 12.9 vs. 94.2 ± 12.0, p < 0.001). Multivariate logistic regression analysis showed that the GNRI (odds ratio—OR, 0.97; 95% confidence interval (CI) 0.95–0.99; p = 0.001), preexisting end-stage renal disease (OR, 3.6; 95% CI, 1.70–7.67; p = 0.001), and ISS (OR, 1.1; 95% CI, 1.05–1.10; p < 0.001) were significant independent risk factors for mortality. Compared to the patients in group of GNRI > 98, those patients in group of GNRI < 82 presented a significantly higher mortality rate (26.6% vs. 13.1%; p < 0.001) and length of stay in hospital (26.5 days vs. 20.9 days; p = 0.016). Conclusions: This study demonstrated that GNRI is a significant independent risk factor and a promising simple screening tool to identify the subjects with malnutrition associated with higher risk for mortality in those ICU elderly trauma patients.
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spelling pubmed-77669042020-12-28 Association between Geriatric Nutritional Risk Index and Mortality in Older Trauma Patients in the Intensive Care Unit Liu, Hang-Tsung Wu, Shao-Chun Tsai, Ching-Hua Li, Chi Chou, Sheng-En Su, Wei-Ti Hsu, Shiun-Yuan Hsieh, Ching-Hua Nutrients Article The geriatric nutritional risk index (GNRI) is a simple and efficient tool to assess the nutritional status of patients with malignancies or after surgery. Because trauma patients constitute a specific population that generally acquires accidental and acute injury, this study aimed to identify the association between the GNRI at admission and mortality outcomes of older trauma patients in the intensive care unit (ICU). Methods: The study population included 700 older trauma patients admitted to the ICU between 1 January 2009 and 31 December 2019. The collected data included age, sex, body mass index (BMI), albumin level at admission, preexisting comorbidities, injury severity score (ISS), and in-hospital mortality. Multivariate logistic regression analysis was conducted to identify the independent effects of univariate predictive variables resulting in mortality in our study population. The study population was categorized into four nutritional risk groups: a major-risk group (GNRI < 82; n = 128), moderate-risk group (GNRI 82 to <92; n = 191), low-risk group (GNRI 92–98; n = 136), and no-risk group (GNRI > 98; n = 245). Results: There was no significant difference in sex predominance, age, and BMI between the mortality (n = 125) and survival (n = 575) groups. The GNRI was significantly lower in the mortality group than in the survival group (89.8 ± 12.9 vs. 94.2 ± 12.0, p < 0.001). Multivariate logistic regression analysis showed that the GNRI (odds ratio—OR, 0.97; 95% confidence interval (CI) 0.95–0.99; p = 0.001), preexisting end-stage renal disease (OR, 3.6; 95% CI, 1.70–7.67; p = 0.001), and ISS (OR, 1.1; 95% CI, 1.05–1.10; p < 0.001) were significant independent risk factors for mortality. Compared to the patients in group of GNRI > 98, those patients in group of GNRI < 82 presented a significantly higher mortality rate (26.6% vs. 13.1%; p < 0.001) and length of stay in hospital (26.5 days vs. 20.9 days; p = 0.016). Conclusions: This study demonstrated that GNRI is a significant independent risk factor and a promising simple screening tool to identify the subjects with malnutrition associated with higher risk for mortality in those ICU elderly trauma patients. MDPI 2020-12-17 /pmc/articles/PMC7766904/ /pubmed/33348716 http://dx.doi.org/10.3390/nu12123861 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Liu, Hang-Tsung
Wu, Shao-Chun
Tsai, Ching-Hua
Li, Chi
Chou, Sheng-En
Su, Wei-Ti
Hsu, Shiun-Yuan
Hsieh, Ching-Hua
Association between Geriatric Nutritional Risk Index and Mortality in Older Trauma Patients in the Intensive Care Unit
title Association between Geriatric Nutritional Risk Index and Mortality in Older Trauma Patients in the Intensive Care Unit
title_full Association between Geriatric Nutritional Risk Index and Mortality in Older Trauma Patients in the Intensive Care Unit
title_fullStr Association between Geriatric Nutritional Risk Index and Mortality in Older Trauma Patients in the Intensive Care Unit
title_full_unstemmed Association between Geriatric Nutritional Risk Index and Mortality in Older Trauma Patients in the Intensive Care Unit
title_short Association between Geriatric Nutritional Risk Index and Mortality in Older Trauma Patients in the Intensive Care Unit
title_sort association between geriatric nutritional risk index and mortality in older trauma patients in the intensive care unit
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7766904/
https://www.ncbi.nlm.nih.gov/pubmed/33348716
http://dx.doi.org/10.3390/nu12123861
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