الفهرس 
AGEING AND DEMOGRAPHYOnly 14 pages are availabe for public view
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Abstract
Background: Elderly are one of the most heterogeneous and vulnerable groups who have a higher risk of nutritional problems. Malnutrition is prevalent among hospitalized elderly but underdiagnosed and almost undistinguishable from the changes in the aging process. The Geriatric Nutritional Risk Index (GNRI) is a tool created to predict nutrition-related complications in hospitalized elderly patients.
Objectives: To measure the prevalence of nutritional risk as determined by the GNRI among hospitalized elderly inpatients. To determine the relationship between GNRI and the occurrence of selected adverse clinical outcomes and evaluate the predictive value of the GNRI.
Methods: A hospital-based follow-up study was conducted among 334 elderly patients admitted to a public geriatric university hospital in Cairo, Egypt from August 2021 to June 2022. Within 48 hours after hospital admission, socio-demographic characteristics, blood biomarkers, anthropometric measurements, and nutritional risk assessment by the GNRI score were obtained. The nutritional risk was divided into three groups: high-nutritional risk (GNRI<92), low-nutritional risk (92-98) and no-risk (GNRI>98). Patients were followed up for the occurrence of different adverse clinical outcomes starting from the date of assessment, during hospital stay (bed sores, healthcare-associated infections (HAIs), hospital length of stay (LOS), and hospital mortality), and for three months after discharge (non-improvement medical status, appearance of new medical conditions, hospital readmission and 90-day mortality). Multivariable regression and survival analysis were conducted.
Results: The prevalence of high nutritional risk was (45.5%, 95% CI, 40% - 51%). Lower GNRI scores (high nutritional risk) were significantly associated with the development of bed sores (Adjusted Odds Ratio (AOR) 3.01; 95% CI, 0.99–9.14), HAIs (AOR: 3.18; 95% CI, 1.48–6.83), prolonged LOS. After discharge, both non-improvement medical status and appearance of new medical conditions were significantly associated with the level of nutritional risk (p value<0.05). Overall survival rate was significantly lower among patients with high nutritional risk compared to those with no risk.
Conclusion: GNRI is a simple and easily applicable nutritional screening tool that had a high prognostic value in this Egyptian sample of patients. Lower GNRI levels are independent risk factors for morbidity and mortality. GNRI could be used in early prediction of nutritional-related complications among hospitalized elderly patients.