The relationship between elderly nutritional risk index and short-term all-cause mortality in critically ill patients with cerebral injury: a retrospective cohort study from two cohorts
BackgroundThe Geriatric Nutritional Risk Index (GNRI) is a simple and objective tool for assessing the risk of malnutrition, with potential practicality in critically ill patients with cerebral injury (CIPCI). However, the current evidence is still limited.MethodPatients diagnosed with cerebral inju...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-07-01
|
| Series: | Frontiers in Nutrition |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2025.1620364/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849303607888838656 |
|---|---|
| author | Zirong Gao Xun Mo Yi Ge Yanhui Lu Shanshan Yu |
| author_facet | Zirong Gao Xun Mo Yi Ge Yanhui Lu Shanshan Yu |
| author_sort | Zirong Gao |
| collection | DOAJ |
| description | BackgroundThe Geriatric Nutritional Risk Index (GNRI) is a simple and objective tool for assessing the risk of malnutrition, with potential practicality in critically ill patients with cerebral injury (CIPCI). However, the current evidence is still limited.MethodPatients diagnosed with cerebral injury were retrospectively retrieved from the Medical Information Marketplace for Intensive Care (MIMIC-IV) and the Affiliated Jinyang Hospital of Guizhou Medical University. Various statistical methods, including restricted cubic spline regression (RCS) regression, multivariate logistic regression, subgroup analyses, and KM survival curves, were used to examine the association between the GNRI index and short-term adverse outcomes in CIPCI. Finally, we used LASSO-COX regression and multifactorial COX regression to develop risk prediction models and assessed the validity of the risk models using subject work characteristics (ROC) curves, area under the ROC (AUC).ResultThe final 1,244 CIPCIs were included in the analysis, of which the 28-day ICU/in-hospital mortality rates were 23.5 and 27.18%, respectively. In the fully adjusted model, continuous GNRI and GNRI category were significantly associated with 28-day ICU/in-hospital mortality, with HRs of, respectively, continuous GNRI: 0.97 (0.96–0.99)/0.97 (0.96–0.99) and [moderate nutritional risk vs. no nutritional risk: 1.66 (1.01–2.74) and 2.03 (1.26–3.28), higher nutritional risk vs. no nutritional risk: 1.79 (1.08–2.97)/2.11 (1.30–3.42)]. Meanwhile, the RCS showed an inverse linear association between continuous GNRI and both 28-day ICU/hospitalization mortality, and this association remained consistent across most subgroups. In addition, the results of the ROC curves showed that the risk model constructed in this study could identify highly-risk CIPCI more effectively than the traditional critical care score. Finally, all results have been further confirmed in the external queue.ConclusionThis study identifies that GNRI is negatively associated with short-term mortality in critically ill patients with cerebral injury and provides a simple and effective tool for risk stratification, allowing clinicians to identify at-risk individuals and provide timely intervention. |
| format | Article |
| id | doaj-art-afc874cfbe1344c09b606e37bb62402d |
| institution | Kabale University |
| issn | 2296-861X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Nutrition |
| spelling | doaj-art-afc874cfbe1344c09b606e37bb62402d2025-08-20T03:56:00ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2025-07-011210.3389/fnut.2025.16203641620364The relationship between elderly nutritional risk index and short-term all-cause mortality in critically ill patients with cerebral injury: a retrospective cohort study from two cohortsZirong GaoXun MoYi GeYanhui LuShanshan YuBackgroundThe Geriatric Nutritional Risk Index (GNRI) is a simple and objective tool for assessing the risk of malnutrition, with potential practicality in critically ill patients with cerebral injury (CIPCI). However, the current evidence is still limited.MethodPatients diagnosed with cerebral injury were retrospectively retrieved from the Medical Information Marketplace for Intensive Care (MIMIC-IV) and the Affiliated Jinyang Hospital of Guizhou Medical University. Various statistical methods, including restricted cubic spline regression (RCS) regression, multivariate logistic regression, subgroup analyses, and KM survival curves, were used to examine the association between the GNRI index and short-term adverse outcomes in CIPCI. Finally, we used LASSO-COX regression and multifactorial COX regression to develop risk prediction models and assessed the validity of the risk models using subject work characteristics (ROC) curves, area under the ROC (AUC).ResultThe final 1,244 CIPCIs were included in the analysis, of which the 28-day ICU/in-hospital mortality rates were 23.5 and 27.18%, respectively. In the fully adjusted model, continuous GNRI and GNRI category were significantly associated with 28-day ICU/in-hospital mortality, with HRs of, respectively, continuous GNRI: 0.97 (0.96–0.99)/0.97 (0.96–0.99) and [moderate nutritional risk vs. no nutritional risk: 1.66 (1.01–2.74) and 2.03 (1.26–3.28), higher nutritional risk vs. no nutritional risk: 1.79 (1.08–2.97)/2.11 (1.30–3.42)]. Meanwhile, the RCS showed an inverse linear association between continuous GNRI and both 28-day ICU/hospitalization mortality, and this association remained consistent across most subgroups. In addition, the results of the ROC curves showed that the risk model constructed in this study could identify highly-risk CIPCI more effectively than the traditional critical care score. Finally, all results have been further confirmed in the external queue.ConclusionThis study identifies that GNRI is negatively associated with short-term mortality in critically ill patients with cerebral injury and provides a simple and effective tool for risk stratification, allowing clinicians to identify at-risk individuals and provide timely intervention.https://www.frontiersin.org/articles/10.3389/fnut.2025.1620364/fullGNRIcerebral injurycritically illmortalityMIMIC |
| spellingShingle | Zirong Gao Xun Mo Yi Ge Yanhui Lu Shanshan Yu The relationship between elderly nutritional risk index and short-term all-cause mortality in critically ill patients with cerebral injury: a retrospective cohort study from two cohorts Frontiers in Nutrition GNRI cerebral injury critically ill mortality MIMIC |
| title | The relationship between elderly nutritional risk index and short-term all-cause mortality in critically ill patients with cerebral injury: a retrospective cohort study from two cohorts |
| title_full | The relationship between elderly nutritional risk index and short-term all-cause mortality in critically ill patients with cerebral injury: a retrospective cohort study from two cohorts |
| title_fullStr | The relationship between elderly nutritional risk index and short-term all-cause mortality in critically ill patients with cerebral injury: a retrospective cohort study from two cohorts |
| title_full_unstemmed | The relationship between elderly nutritional risk index and short-term all-cause mortality in critically ill patients with cerebral injury: a retrospective cohort study from two cohorts |
| title_short | The relationship between elderly nutritional risk index and short-term all-cause mortality in critically ill patients with cerebral injury: a retrospective cohort study from two cohorts |
| title_sort | relationship between elderly nutritional risk index and short term all cause mortality in critically ill patients with cerebral injury a retrospective cohort study from two cohorts |
| topic | GNRI cerebral injury critically ill mortality MIMIC |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2025.1620364/full |
| work_keys_str_mv | AT zironggao therelationshipbetweenelderlynutritionalriskindexandshorttermallcausemortalityincriticallyillpatientswithcerebralinjuryaretrospectivecohortstudyfromtwocohorts AT xunmo therelationshipbetweenelderlynutritionalriskindexandshorttermallcausemortalityincriticallyillpatientswithcerebralinjuryaretrospectivecohortstudyfromtwocohorts AT yige therelationshipbetweenelderlynutritionalriskindexandshorttermallcausemortalityincriticallyillpatientswithcerebralinjuryaretrospectivecohortstudyfromtwocohorts AT yanhuilu therelationshipbetweenelderlynutritionalriskindexandshorttermallcausemortalityincriticallyillpatientswithcerebralinjuryaretrospectivecohortstudyfromtwocohorts AT shanshanyu therelationshipbetweenelderlynutritionalriskindexandshorttermallcausemortalityincriticallyillpatientswithcerebralinjuryaretrospectivecohortstudyfromtwocohorts AT zironggao relationshipbetweenelderlynutritionalriskindexandshorttermallcausemortalityincriticallyillpatientswithcerebralinjuryaretrospectivecohortstudyfromtwocohorts AT xunmo relationshipbetweenelderlynutritionalriskindexandshorttermallcausemortalityincriticallyillpatientswithcerebralinjuryaretrospectivecohortstudyfromtwocohorts AT yige relationshipbetweenelderlynutritionalriskindexandshorttermallcausemortalityincriticallyillpatientswithcerebralinjuryaretrospectivecohortstudyfromtwocohorts AT yanhuilu relationshipbetweenelderlynutritionalriskindexandshorttermallcausemortalityincriticallyillpatientswithcerebralinjuryaretrospectivecohortstudyfromtwocohorts AT shanshanyu relationshipbetweenelderlynutritionalriskindexandshorttermallcausemortalityincriticallyillpatientswithcerebralinjuryaretrospectivecohortstudyfromtwocohorts |