Is the Geriatric Nutrition Risk Index (GBRI) a New Prognostic Tool for Older Adults with COPD?
Analysis of a Study
Nutrition is an important factor that directly affects health outcomes, especially in the elderly. How nutritional status affects the course of disease and mortality risk in patients with chronic conditions such as Chronic Obstructive Pulmonary Disease (COPD) has long been discussed. One of the important studies in this field is “The Relationship Between Geriatric Nutritional Risk Index and 90-Day Mortality: Retrospective Cohort Study in Older Adults with Chronic Obstructive Pulmonary Disease” and has been discussed in detail by the researchers. In this article, as a Nutritionist, I have analyzed the relevant study for you and present its findings in terms of clinical practice.
What is GBRI and How is it Calculated?
The Geriatric Nutrition Risk Index (GBRI), which was evaluated in the study, is a scoring system used to measure nutritional status in elderly patients. Parameters such as height, weight and albumin level are used in the calculation. The formula is as follows: GBRI = 1.489 × Albumin + 41.7 × (Weight / (22 × Height²)) The resulting score is divided into four categories according to the nutritional status of the person:
- GNRI > 98: Normal nutritional status
- GNRI = 92-98: Mild malnutrition
- GNRI = 82-91: Moderate malnutrition
- GNRI < 81: Severe malnutrition
Methodology and Findings of the Study
In this study, data of COPD patients aged 65 years and older admitted to the intensive care unit (ICU) at Beth Israel Deaconess Medical Center between 2008 and 2019 were analyzed. The total patient group was divided into four categories according to their GBRI scores and 90-day mortality rates were assessed. The results revealed that patients with low GNRI scores had a higher risk of death within 90 days compared to those with normal nutritional status. The L-shaped relationship observed in the study indicates that mortality increases significantly when the GNRI value falls below a certain threshold level. In particular, patients with a GNRI < 81 were found to have a 1.27-fold higher risk of death compared to those with a GNRI > 98. This suggests that the GNRI may be a valuable tool for detecting malnutrition and predicting mortality risk in older patients with COPD.
Clinical Significance of GBRI
- A Simple and Objective Measure: It is easy to calculate and can be integrated with many clinical parameters.
- Enables Early Intervention: Early identification of at-risk patients can enable timely implementation of nutritional support and other interventions.
- Area of Use in Intensive Care: It offers a method applicable in critical patient groups such as COPD patients in ICU.
Strengths and Weaknesses of the Study
The study was conducted with large-scale patient data from the MIMIC-IV database and included multivariate analyses. However, it has some limitations due to its retrospective and observational design. In particular, factors such as dietary patterns and gut microbiota were not included in the study. This research suggests that the GNRI may be an effective tool for predicting mortality in older adults with COPD. Closer follow-up of individuals with low GNRI scores and supporting them with nutritional interventions may improve health outcomes. Nutritional risk assessment is an important factor that directly affects survival and quality of life in critically ill patients. Therefore, integrating reliable and easy-to-implement tools such as GBRI into clinical practice can make a big difference in patient care. Source; https://pubmed.ncbi.nlm.nih.gov/38831891/
