The role of Geriatric Nutritional Risk Index in sepsis-related mortality in intensive care

Authors : Dursun Elmas, Mahmut Sami İnce

Pages : 180-185

Doi:10.32322/jhsm.1592706

View : 47 | Download : 40

Publication Date : 2025-03-21

Article Type : Research Paper

Abstract :Aims: This study explores the link between nutritional status and sepsis outcomes, focusing on Geriatric Nutritional Risk Index (GNRI) scores and clinical endpoints such as mortality, intensive care unit (ICU) stay duration, and functional recovery. Methods: The study was a retrospective, observational investigation of 250 older patients with sepsis in the intensive care unit. GNRI was calculated based on admission albumin level and ratio of actual body weight to ideal body weight. Groups were defined as major risk (GNRI 98). The primary outcome measured was 28-day hospital mortality. Additionally, the relationship between the GNRI score and the SOFA and APACHE II scores was assessed. Results: In the univariate analysis comparing median values between survivor and non-survivor groups, significant differences were found in body-mass index, albumin levels, C-reactive protein levels, SOFA score, APACHE II score, and GNRI score. The 28-day hospital mortality rates for each GNRI group were: 5.7% in the very low risk group (GNRI >98), 9.8% in the low risk group (GNRI 92-98), 8.5% in the moderate risk group (GNRI 82-92), and 35.8% in the very high risk group (GNRI <82). The optimal cutoff for predicting outcomes was identified as GNRI <85. In a comparison of area under the curve (AUC) values, GNRI demonstrated superior predictive ability compared to APACHE II and SOFA scores, with AUC values of 0.629 (95% CI 0.543-0.715) for GNRI, 0.579 (95% CI 0.493-0.664) for SOFA, and 0.550 (95% CI 0.455-0.646) for APACHE II. Conclusion: This study demonstrates that GNRI is a significant predictor of mortality and prolonged length of stay in patients with sepsis in the ICU. These findings underscore the importance of assessing and improving nutritional status in the management of sepsis.
Keywords : Geriatrik Beslenme Riski Endeksi, sepsis, yetersiz beslenme, mortalite