JHSM
Journal of Health Sciences and Medicine

Journal of Health Sciences and Medicine (JHSM) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

ISSN: Active
eISSN: 2636-8579
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Submit Manuscript

Index
Original Article
The role of Geriatric Nutritional Risk Index in sepsis-related mortality in intensive care
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 <82), moderate risk (GNRI 82 to <92), low risk (GNRI 92 to ?98), and no 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 : Geriatric Nutritional Risk Index, sepsis, malnutrition, mortality

Download Article


1. Angus DC, van der Poll T. Severe sepsis and septic shock. N Engl J Med. 2013;369(9):840-851. doi: 10.1056/NEJMra1208623
2. Singer M, Deutschman CS, Seymour CW, et al. The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA. 2016; 315(8):801-810. doi:10.1001/jama.2016.0287
3. Cederholm T, Jensen GL, Correia MITD, et.al. GLIM criteria for the diagnosis of malnutrition-a consensus report from the global clinical nutrition community. Clin Nutr. 2019;38(1):1-9. doi:10.1016/j.clnu.2018. 08.002
4. Bouillanne O, Morineau G, Dupant C, et al. Geriatric Nutritional Risk Index: a new index for evaluating at-risk elderly medical patients. Am J Clin Nutr. 2005;82(4):777-783. doi:10.1093/ajcn/82.4.777
5. Bauer JM, Kaiser MJ, Anthony P, Guigoz Y, Sieber CC. The mini nutritional assessment-its history, today&rsquo;s practice, and future perspectives.Nutr Clin Pract. 2008;23(4):388-396. doi:10.1177/0884533608321132
6. Stratton RJ, Hackston A, Longmore D, et al. Malnutrition in hospital outpatients and inpatients: prevalence, concurrent validity and ease of use of the &lsquo;malnutrition universal screening tool&rsquo; (&lsquo;MUST&rsquo;) for adults. Br J Nutr. 2004;92(5):799-808. doi:10.1079/bjn20041258
7. Lee JS, Choi HS, Ko YG, Yun DH. Performance of the Geriatric Nutritional Risk Index in predicting 28-day hospital mortality in older adult patients with sepsis. Clin Nutr. 2013;32:843-848. doi:10.1016/j.clnu.2013.01.007
8. Dur&aacute;n Alert P, Mil&agrave; Villarroel R, Formiga F, Virgili Casas N, Vilarasau Farr&eacute; C. Assessing risk screening methods of malnutrition in geriatric patients: mini nutritional assessment (MNA) versus Geriatric Nutritional Risk Index (GNRI). Nutr Hosp. 2012;27(2):590-598. doi:10. 1590/S0212-16112012000200036
9. Haas M, Lein A, Fuereder T, et al. The Geriatric Nutritional Risk Index (GNRI) as a prognostic biomarker for immune checkpoint inhibitor response in recurrent and/or metastatic head and neck cancer. Nutrients. 2023;15(4):880. doi:10.3390/nu15040880
10. Xie H, Tang S, Wei L, Gan J. Geriatric Nutritional Risk Index as a predictor of complications and long-term outcomes in patients with gastrointestinal malignancy: a systematic review and meta-analysis. Cancer Cell Int. 2020;20(1):530. doi:10.1186/s12935-020-01628-7
11. Li H, Cen K, Sun W, Feng B. Prognostic value of geriatric nutritional risk index in elderly patients with heart failure: a meta-analysis. Aging Clin Exp Res. 2021;33(6):1477-1486. doi:10.1007/s40520-020-01656-3
12. Yamada S, Yamamoto S, Fukuma S, Nakano T, Tsuruya K, Inaba M. Geriatric Nutritional Risk Index (GNRI) and Creatinine Index equally predict the risk of mortality in hemodialysis patients: J-DOPPS. Sci Rep. 2020;10(1):5756. doi:10.1038/s41598-020-62720-6
13. Zhao D, Zhou D, Li T, Wang C, Fei S. The relationship between Geriatric Nutritional Risk Index (GNRI) and in-hospital mortality in critically ill patients with acute kidney injury (AKI). BMC Anesthesiol. 2024;24(1): 313. doi:10.1186/s12871-024-02689-1
14. Plauth M, Sulz I, Viertel M, et al. Phase angle is a stronger predictor of hospital outcome than subjective global assessment-results from the prospective dessau hospital malnutrition study. Nutrients. 2022;14(9): 1780. doi:10.3390/nu14091780
15. Cereda E, Pedrolli C, Zagami A, et al. Nutritional screening and mortality in newly institutionalised elderly: a comparison between the Geriatric Nutritional Risk Index and the mini nutritional assessment. Clin Nutr. 2011;30(6):793-798. doi:10.1016/j.clnu.2011.04.006
Article available in :
Volume 8, Issue 2, 2025
Page : 180-185
https://doi.org/10.32322/jhsm.1592706
Article Information
Received : 28 Kas 2024
Accepted : 24 Oca 2025
Published : 21 Mar 2025
Corresponding Author :

Dursun Elmas: Division of Intensive Care, Department of Internal Medicine, Konya City Hospital, Konya, Turkiye

[email protected]
Citation : Elmas D, İnce MS. The role of Geriatric Nutritional Risk Index in sepsis-related mortality in intensive care. J Health Sci Med. 2025;8(2):180-185.

Read: 12
Cited: 0
Download : 20
_Footer