Association between geriatric nutritional risk index and adverse outcomes in critical ill patients with chronic obstructive pulmonary disease: a cohort study of 2824 older adults
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide, particularly among the elderly, resulting in high rates of intensive care unit (ICU) admissions. Malnutrition is common in elderly patients and has been associated with poor prognosis in patients wi...
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| Veröffentlicht in: | BMC pulmonary medicine 2024-12, Vol.24 (1), p.634-11 |
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| creator | Feng, Mei Liu, Yixiang Li, Qiugui Yang, Xin Wei, Fangxin Cheng, Hongtao Lyu, Jun Lin, Qingran |
| description | Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide, particularly among the elderly, resulting in high rates of intensive care unit (ICU) admissions. Malnutrition is common in elderly patients and has been associated with poor prognosis in patients with COPD. However, its impact in the ICU setting remains incompletely defined. The objective of this study is to examine the association between malnutrition, as measured by the Geriatric Nutritional Risk Index (GNRI), and adverse outcomes in older patients with COPD in the ICU.
A cohort study of 2,824 older COPD patients admitted to the ICU from 2008 to 2019 was conducted. The association between GNRI scores and outcomes including in-hospital mortality, risk of pressure injuries, and length of ICU stay was evaluated. Odds ratios (OR) and 95% confidence intervals (CI) were calculated. A causal mediation analysis was employed to identify potential mediating variables and to calculate the proportion mediated.
The median age of study participants was approximately 75 years, with 1,281 (45.4%) being female. Lower GNRI scores (GNRI ≤ 98) were significantly associated with increased in-hospital mortality (OR: 1.48, 95% CI: 1.08-2.05, p = 0.015), higher incidence of pressure injuries (OR: 1.97, 95% CI: 1.54-2.54, p |
| doi_str_mv | 10.1186/s12890-024-03454-3 |
| format | Article |
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A cohort study of 2,824 older COPD patients admitted to the ICU from 2008 to 2019 was conducted. The association between GNRI scores and outcomes including in-hospital mortality, risk of pressure injuries, and length of ICU stay was evaluated. Odds ratios (OR) and 95% confidence intervals (CI) were calculated. A causal mediation analysis was employed to identify potential mediating variables and to calculate the proportion mediated.
The median age of study participants was approximately 75 years, with 1,281 (45.4%) being female. Lower GNRI scores (GNRI ≤ 98) were significantly associated with increased in-hospital mortality (OR: 1.48, 95% CI: 1.08-2.05, p = 0.015), higher incidence of pressure injuries (OR: 1.97, 95% CI: 1.54-2.54, p < 0.001), and longer ICU stays (OR: 1.51, 95% CI: 1.18-1.94, p = 0.001). Mediation analysis indicated that pressure injury accounted for approximately 22.9% of the association between malnutrition and in-hospital mortality.
Lower GNRI scores, indicative of malnutrition, are associated with adverse outcomes in elderly ICU patients with COPD. The findings highlight the importance of early nutritional assessment and intervention in this high-risk group to improve survival and reduce complications.</description><identifier>ISSN: 1471-2466</identifier><identifier>EISSN: 1471-2466</identifier><identifier>DOI: 10.1186/s12890-024-03454-3</identifier><identifier>PMID: 39732680</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Aged ; Aged patients ; Aged, 80 and over ; Chronic obstructive pulmonary disease ; Cohort Studies ; Critical Illness ; Diseases ; Female ; Geriatric Assessment ; Geriatric nutritional risk index ; Hospital Mortality ; Hospital patients ; Humans ; Intensive care unit ; Intensive Care Units - statistics & numerical data ; Length of Stay - statistics & numerical data ; Lung diseases, Obstructive ; Male ; Malnutrition ; Malnutrition - complications ; Malnutrition - epidemiology ; Mediation ; Medical research ; Medicine, Experimental ; Mortality ; Nutrition ; Nutrition Assessment ; Nutritional Status ; Patient outcomes ; Pressure injuries ; Pressure Ulcer - epidemiology ; Product/Service Evaluations ; Prognosis ; Pulmonary Disease, Chronic Obstructive - complications ; Pulmonary Disease, Chronic Obstructive - epidemiology ; Pulmonary Disease, Chronic Obstructive - mortality ; Retrospective Studies ; Risk Assessment ; Risk Factors ; United Kingdom</subject><ispartof>BMC pulmonary medicine, 2024-12, Vol.24 (1), p.634-11</ispartof><rights>2024. The Author(s).</rights><rights>COPYRIGHT 2024 BioMed Central Ltd.</rights><rights>The Author(s) 2024 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11682637/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11682637/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39732680$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Feng, Mei</creatorcontrib><creatorcontrib>Liu, Yixiang</creatorcontrib><creatorcontrib>Li, Qiugui</creatorcontrib><creatorcontrib>Yang, Xin</creatorcontrib><creatorcontrib>Wei, Fangxin</creatorcontrib><creatorcontrib>Cheng, Hongtao</creatorcontrib><creatorcontrib>Lyu, Jun</creatorcontrib><creatorcontrib>Lin, Qingran</creatorcontrib><title>Association between geriatric nutritional risk index and adverse outcomes in critical ill patients with chronic obstructive pulmonary disease: a cohort study of 2824 older adults</title><title>BMC pulmonary medicine</title><addtitle>BMC Pulm Med</addtitle><description>Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide, particularly among the elderly, resulting in high rates of intensive care unit (ICU) admissions. Malnutrition is common in elderly patients and has been associated with poor prognosis in patients with COPD. However, its impact in the ICU setting remains incompletely defined. The objective of this study is to examine the association between malnutrition, as measured by the Geriatric Nutritional Risk Index (GNRI), and adverse outcomes in older patients with COPD in the ICU.
A cohort study of 2,824 older COPD patients admitted to the ICU from 2008 to 2019 was conducted. The association between GNRI scores and outcomes including in-hospital mortality, risk of pressure injuries, and length of ICU stay was evaluated. Odds ratios (OR) and 95% confidence intervals (CI) were calculated. A causal mediation analysis was employed to identify potential mediating variables and to calculate the proportion mediated.
The median age of study participants was approximately 75 years, with 1,281 (45.4%) being female. Lower GNRI scores (GNRI ≤ 98) were significantly associated with increased in-hospital mortality (OR: 1.48, 95% CI: 1.08-2.05, p = 0.015), higher incidence of pressure injuries (OR: 1.97, 95% CI: 1.54-2.54, p < 0.001), and longer ICU stays (OR: 1.51, 95% CI: 1.18-1.94, p = 0.001). Mediation analysis indicated that pressure injury accounted for approximately 22.9% of the association between malnutrition and in-hospital mortality.
Lower GNRI scores, indicative of malnutrition, are associated with adverse outcomes in elderly ICU patients with COPD. The findings highlight the importance of early nutritional assessment and intervention in this high-risk group to improve survival and reduce complications.</description><subject>Aged</subject><subject>Aged patients</subject><subject>Aged, 80 and over</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Cohort Studies</subject><subject>Critical Illness</subject><subject>Diseases</subject><subject>Female</subject><subject>Geriatric Assessment</subject><subject>Geriatric nutritional risk index</subject><subject>Hospital Mortality</subject><subject>Hospital patients</subject><subject>Humans</subject><subject>Intensive care unit</subject><subject>Intensive Care Units - statistics & numerical data</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Lung diseases, Obstructive</subject><subject>Male</subject><subject>Malnutrition</subject><subject>Malnutrition - complications</subject><subject>Malnutrition - epidemiology</subject><subject>Mediation</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Mortality</subject><subject>Nutrition</subject><subject>Nutrition Assessment</subject><subject>Nutritional Status</subject><subject>Patient outcomes</subject><subject>Pressure injuries</subject><subject>Pressure Ulcer - epidemiology</subject><subject>Product/Service Evaluations</subject><subject>Prognosis</subject><subject>Pulmonary Disease, Chronic Obstructive - complications</subject><subject>Pulmonary Disease, Chronic Obstructive - epidemiology</subject><subject>Pulmonary Disease, Chronic Obstructive - mortality</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>United Kingdom</subject><issn>1471-2466</issn><issn>1471-2466</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>DOA</sourceid><recordid>eNpVkstuFDEQRVsIRELgB1ggL9l08Gv8YINGEY9IkdjAuuUuV884eOzB7p6Q3-ILcZiAEnlR1q3r4-uSu-41o-eMGfWuMm4s7SmXPRVyJXvxpDtlUrOeS6WePtifdC9qvaaUabMSz7sTYbXgytDT7ve61gzBzSEnMuJ8g5jIBktTSgCSllbuei6SEuoPEpLHX8QlT5w_YKlI8jJD3mFtLQJ3ZmjeECPZNyimuZKbMG8JbEtOjZjHOpcF5nBAsl_irqHLLfGhoqv4njgCeZvLTOq8-FuSJ8INlyRHj6VducS5vuyeTS5WfHVfz7rvnz5-u_jSX339fHmxvuo9Z1r3zHlrORth5GLyaqIWGUfPFLduxTlYJRXoEY2QXK40RxgFs6AmsJPjAOKsuzxyfXbXw76EXUs6ZBeGv0Ium8GV9tyIA_fSOcusYqOWGqgTGjgwow0KLS021ocja7-MO_TQ5lJcfAR93ElhO2zyYWBMGa6EboS394SSfy5Y52EXKmCMLmFe6iCYtKaNStBmPT9aN65lC2nKDQltedwFyAmn0PS1aWOiRgvVDrx5mO5_rH_fRPwBmVHESw</recordid><startdate>20241228</startdate><enddate>20241228</enddate><creator>Feng, Mei</creator><creator>Liu, Yixiang</creator><creator>Li, Qiugui</creator><creator>Yang, Xin</creator><creator>Wei, Fangxin</creator><creator>Cheng, Hongtao</creator><creator>Lyu, Jun</creator><creator>Lin, Qingran</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20241228</creationdate><title>Association between geriatric nutritional risk index and adverse outcomes in critical ill patients with chronic obstructive pulmonary disease: a cohort study of 2824 older adults</title><author>Feng, Mei ; Liu, Yixiang ; Li, Qiugui ; Yang, Xin ; Wei, Fangxin ; Cheng, Hongtao ; Lyu, Jun ; Lin, Qingran</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-d2177-1ad9921bcb23fd6f09e12ed1629a522c9646c7be83424572ecb319c6fc9fa2cc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Aged patients</topic><topic>Aged, 80 and over</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Cohort Studies</topic><topic>Critical Illness</topic><topic>Diseases</topic><topic>Female</topic><topic>Geriatric Assessment</topic><topic>Geriatric nutritional risk index</topic><topic>Hospital Mortality</topic><topic>Hospital patients</topic><topic>Humans</topic><topic>Intensive care unit</topic><topic>Intensive Care Units - statistics & numerical data</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Lung diseases, Obstructive</topic><topic>Male</topic><topic>Malnutrition</topic><topic>Malnutrition - complications</topic><topic>Malnutrition - epidemiology</topic><topic>Mediation</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Mortality</topic><topic>Nutrition</topic><topic>Nutrition Assessment</topic><topic>Nutritional Status</topic><topic>Patient outcomes</topic><topic>Pressure injuries</topic><topic>Pressure Ulcer - epidemiology</topic><topic>Product/Service Evaluations</topic><topic>Prognosis</topic><topic>Pulmonary Disease, Chronic Obstructive - complications</topic><topic>Pulmonary Disease, Chronic Obstructive - epidemiology</topic><topic>Pulmonary Disease, Chronic Obstructive - mortality</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>United Kingdom</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Feng, Mei</creatorcontrib><creatorcontrib>Liu, Yixiang</creatorcontrib><creatorcontrib>Li, Qiugui</creatorcontrib><creatorcontrib>Yang, Xin</creatorcontrib><creatorcontrib>Wei, Fangxin</creatorcontrib><creatorcontrib>Cheng, Hongtao</creatorcontrib><creatorcontrib>Lyu, Jun</creatorcontrib><creatorcontrib>Lin, Qingran</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>BMC pulmonary medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Feng, Mei</au><au>Liu, Yixiang</au><au>Li, Qiugui</au><au>Yang, Xin</au><au>Wei, Fangxin</au><au>Cheng, Hongtao</au><au>Lyu, Jun</au><au>Lin, Qingran</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association between geriatric nutritional risk index and adverse outcomes in critical ill patients with chronic obstructive pulmonary disease: a cohort study of 2824 older adults</atitle><jtitle>BMC pulmonary medicine</jtitle><addtitle>BMC Pulm Med</addtitle><date>2024-12-28</date><risdate>2024</risdate><volume>24</volume><issue>1</issue><spage>634</spage><epage>11</epage><pages>634-11</pages><issn>1471-2466</issn><eissn>1471-2466</eissn><abstract>Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide, particularly among the elderly, resulting in high rates of intensive care unit (ICU) admissions. Malnutrition is common in elderly patients and has been associated with poor prognosis in patients with COPD. However, its impact in the ICU setting remains incompletely defined. The objective of this study is to examine the association between malnutrition, as measured by the Geriatric Nutritional Risk Index (GNRI), and adverse outcomes in older patients with COPD in the ICU.
A cohort study of 2,824 older COPD patients admitted to the ICU from 2008 to 2019 was conducted. The association between GNRI scores and outcomes including in-hospital mortality, risk of pressure injuries, and length of ICU stay was evaluated. Odds ratios (OR) and 95% confidence intervals (CI) were calculated. A causal mediation analysis was employed to identify potential mediating variables and to calculate the proportion mediated.
The median age of study participants was approximately 75 years, with 1,281 (45.4%) being female. Lower GNRI scores (GNRI ≤ 98) were significantly associated with increased in-hospital mortality (OR: 1.48, 95% CI: 1.08-2.05, p = 0.015), higher incidence of pressure injuries (OR: 1.97, 95% CI: 1.54-2.54, p < 0.001), and longer ICU stays (OR: 1.51, 95% CI: 1.18-1.94, p = 0.001). Mediation analysis indicated that pressure injury accounted for approximately 22.9% of the association between malnutrition and in-hospital mortality.
Lower GNRI scores, indicative of malnutrition, are associated with adverse outcomes in elderly ICU patients with COPD. The findings highlight the importance of early nutritional assessment and intervention in this high-risk group to improve survival and reduce complications.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>39732680</pmid><doi>10.1186/s12890-024-03454-3</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged patients Aged, 80 and over Chronic obstructive pulmonary disease Cohort Studies Critical Illness Diseases Female Geriatric Assessment Geriatric nutritional risk index Hospital Mortality Hospital patients Humans Intensive care unit Intensive Care Units - statistics & numerical data Length of Stay - statistics & numerical data Lung diseases, Obstructive Male Malnutrition Malnutrition - complications Malnutrition - epidemiology Mediation Medical research Medicine, Experimental Mortality Nutrition Nutrition Assessment Nutritional Status Patient outcomes Pressure injuries Pressure Ulcer - epidemiology Product/Service Evaluations Prognosis Pulmonary Disease, Chronic Obstructive - complications Pulmonary Disease, Chronic Obstructive - epidemiology Pulmonary Disease, Chronic Obstructive - mortality Retrospective Studies Risk Assessment Risk Factors United Kingdom |
| title | Association between geriatric nutritional risk index and adverse outcomes in critical ill patients with chronic obstructive pulmonary disease: a cohort study of 2824 older adults |
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