Evaluation of the Geriatric Nutritional Risk Index in predicting mortality in older patients with COVID-19 in the AgeBru cohort

De Meester, Dorien; Goossens, Mathijs; Marco Navarro, Ester; Claessens, Marie; Gautier, Jennifer; Annweiler, Cédric; Lieten, Siddhartha; Benoit, Florence; Surquin, Murielle; Sánchez-Rodríguez, María Dolores

doi:http://dx.doi.org/10.1016/j.clnesp.2023.06.025

Evaluation of the Geriatric Nutritional Risk Index in predicting mortality in older patients with COVID-19 in the AgeBru cohort

Citation

De Meester D, Goossens M, Marco E, Claessens M, Gautier J, Annweiler C, et al. Evaluation of the Geriatric Nutritional Risk Index in predicting mortality in older patients with COVID-19 in the AgeBru cohort. Clin Nutr ESPEN. 2023 Oct;57:65-72. DOI: 10.1016/j.clnesp.2023.06.025

Abstract

Objective: To determine whether the Geriatric Nutritional Risk Index (GNRI) on hospital admission was associated to an increased 14-day and 12-month mortality-risk in older inpatients with COVID-19. Methods: Cohort study of consecutive inpatients admitted with COVID-19 in a university hospital (20/03/2020-11/05/2021). Inclusion criteria: age over 65 years and positive polymerase chain reaction test. Exclusion criteria: missing data for weight, height, and/or albumin, hospital-acquired COVID-19, or patients transferred to other health facilities. Outcome: all-cause mortality at 14-day and 12-month follow-up. GNRI [1.489 × albumin (g/L)] + [41.7 (weight/ideal body weight)] was assessed at admission; scores ≤98 indicated risk of malnutrition. Cox-proportional hazards models assessed the association between the admission GNRI and 14-day and 12-month mortality-risk, after adjusting by demographic and clinical variables, including inflammation (C-reactive protein). Results: Of the 570 eligible patients, 224 (mean age 78 years; 52.2% women) met inclusion criteria and 151 (67.4%) were classified at risk of malnutrition. Twenty patients died during the 14-day and 42 during the 12-month follow-up. The risk of 14-day mortality was nearly 10 times higher in patients with GNRI scores ≤98 (HR = 9.6 [95%CI 1.3-71.6], P = 0.028); this association was marginally significant in the adjusted model (HR = 6.73 [95%CI 0.89-51.11], P = 0.065)]. No association between GNRI and the 12-month mortality-risk was found. Conclusions: The GNRI may play a role in the short-term prognosis of older inpatients with COVID-19. Further studies are required to confirm the short-term predictive validity of the GNRI within this population (Clinicaltrials.gov_NCT05276752).