Impact of the Geriatric Nutritional Risk Index on short-term prognosis of patients with sepsis-related acute kidney injury: analysis using the MIMIC-IV database
Abstract Background In critically ill elderly patients, malnutrition is a common comorbidity. The Geriatric Nutritional Risk Index (GNRI) is a straightforward tool for evaluating the nutritional status of elderly individuals. The association between GNRI score and unfavorable health outcomes has bee...
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BMC
2025-04-01
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| Series: | BMC Nephrology |
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| Online Access: | https://doi.org/10.1186/s12882-025-04122-2 |
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| author | Kailun Cai Wenchao Mao Mingkun Yang Changqin Chen Shijin Gong Lifen Zheng Changyun Zhao |
| author_facet | Kailun Cai Wenchao Mao Mingkun Yang Changqin Chen Shijin Gong Lifen Zheng Changyun Zhao |
| author_sort | Kailun Cai |
| collection | DOAJ |
| description | Abstract Background In critically ill elderly patients, malnutrition is a common comorbidity. The Geriatric Nutritional Risk Index (GNRI) is a straightforward tool for evaluating the nutritional status of elderly individuals. The association between GNRI score and unfavorable health outcomes has been established. However, no studies have yet elucidated the relationship between GNRI score and sepsis-related acute kidney injury (S-AKI). Methods We sourced patient data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. All patients were divided into four groups based on their GNRI score using quartile analysis. The main objective of this study was to investigate the 28-day mortality rate. Secondary study outcomes were the incidence of severe AKI, length of stay in the intensive care unit, and days in the hospital. To evaluate the association between GNRI score and study outcomes, we used a Cox proportional hazards regression model and restricted cubic splines. Kaplan–Meier curves were used to compare the outcomes in each group. Results A total of 4515 elderly patients with S-AKI were included in this study. Patients were categorized into four groups according to GNRI quartile: Q1 (< 78.92), Q2 (78.92–84.88), Q3 (84.88–90.84), and Q4 (> 90.84). Overall 28-day mortality was 29.5%. Patients with a low GNRI were predominantly women, and had a low body mass index. After controlling for confounding factors, GNRI score emerged as an independent predictor of 28-day mortality among elderly patients with S-AKI (Q4 vs. Q1: hazard ratio 0.74, 95% confidence interval 0.63–0.87; p < 0.001). Restricted cubic spline analysis revealed a linear relationship between GNRI and 28-day mortality (p for non-linearity = 0.207), and this association remained consistent across all subgroup analyses. Conclusions The GNRI is an important nutritional assessment tool, and is useful in predicting the prognosis of critically ill elderly patients with S- AKI. |
| format | Article |
| id | doaj-art-bfdfc1e469e04b00a454140eaa697fa5 |
| institution | OA Journals |
| issn | 1471-2369 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj-art-bfdfc1e469e04b00a454140eaa697fa52025-08-20T02:19:55ZengBMCBMC Nephrology1471-23692025-04-0126111010.1186/s12882-025-04122-2Impact of the Geriatric Nutritional Risk Index on short-term prognosis of patients with sepsis-related acute kidney injury: analysis using the MIMIC-IV databaseKailun Cai0Wenchao Mao1Mingkun Yang2Changqin Chen3Shijin Gong4Lifen Zheng5Changyun Zhao6Department of Critical Care Medicine, Zhejiang HospitalDepartment of Critical Care Medicine, Zhejiang HospitalDepartment of Second Clinical Medical College, Zhejiang Chinese Medicine UniversityDepartment of Critical Care Medicine, Zhejiang HospitalDepartment of Critical Care Medicine, Zhejiang HospitalChronic Disease Management Center, Quzhou Kecheng People’s HospitalDepartment of Critical Care Medicine, Zhejiang HospitalAbstract Background In critically ill elderly patients, malnutrition is a common comorbidity. The Geriatric Nutritional Risk Index (GNRI) is a straightforward tool for evaluating the nutritional status of elderly individuals. The association between GNRI score and unfavorable health outcomes has been established. However, no studies have yet elucidated the relationship between GNRI score and sepsis-related acute kidney injury (S-AKI). Methods We sourced patient data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. All patients were divided into four groups based on their GNRI score using quartile analysis. The main objective of this study was to investigate the 28-day mortality rate. Secondary study outcomes were the incidence of severe AKI, length of stay in the intensive care unit, and days in the hospital. To evaluate the association between GNRI score and study outcomes, we used a Cox proportional hazards regression model and restricted cubic splines. Kaplan–Meier curves were used to compare the outcomes in each group. Results A total of 4515 elderly patients with S-AKI were included in this study. Patients were categorized into four groups according to GNRI quartile: Q1 (< 78.92), Q2 (78.92–84.88), Q3 (84.88–90.84), and Q4 (> 90.84). Overall 28-day mortality was 29.5%. Patients with a low GNRI were predominantly women, and had a low body mass index. After controlling for confounding factors, GNRI score emerged as an independent predictor of 28-day mortality among elderly patients with S-AKI (Q4 vs. Q1: hazard ratio 0.74, 95% confidence interval 0.63–0.87; p < 0.001). Restricted cubic spline analysis revealed a linear relationship between GNRI and 28-day mortality (p for non-linearity = 0.207), and this association remained consistent across all subgroup analyses. Conclusions The GNRI is an important nutritional assessment tool, and is useful in predicting the prognosis of critically ill elderly patients with S- AKI.https://doi.org/10.1186/s12882-025-04122-2Geriatric Nutritional Risk IndexSepsisSepsis-related acute kidney injuryElderly |
| spellingShingle | Kailun Cai Wenchao Mao Mingkun Yang Changqin Chen Shijin Gong Lifen Zheng Changyun Zhao Impact of the Geriatric Nutritional Risk Index on short-term prognosis of patients with sepsis-related acute kidney injury: analysis using the MIMIC-IV database BMC Nephrology Geriatric Nutritional Risk Index Sepsis Sepsis-related acute kidney injury Elderly |
| title | Impact of the Geriatric Nutritional Risk Index on short-term prognosis of patients with sepsis-related acute kidney injury: analysis using the MIMIC-IV database |
| title_full | Impact of the Geriatric Nutritional Risk Index on short-term prognosis of patients with sepsis-related acute kidney injury: analysis using the MIMIC-IV database |
| title_fullStr | Impact of the Geriatric Nutritional Risk Index on short-term prognosis of patients with sepsis-related acute kidney injury: analysis using the MIMIC-IV database |
| title_full_unstemmed | Impact of the Geriatric Nutritional Risk Index on short-term prognosis of patients with sepsis-related acute kidney injury: analysis using the MIMIC-IV database |
| title_short | Impact of the Geriatric Nutritional Risk Index on short-term prognosis of patients with sepsis-related acute kidney injury: analysis using the MIMIC-IV database |
| title_sort | impact of the geriatric nutritional risk index on short term prognosis of patients with sepsis related acute kidney injury analysis using the mimic iv database |
| topic | Geriatric Nutritional Risk Index Sepsis Sepsis-related acute kidney injury Elderly |
| url | https://doi.org/10.1186/s12882-025-04122-2 |
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