Predictive Value of Geriatric Nutritional Risk Index for Readmission within 6-Months in Elderly Inpatients with Acute Exacerbation Chronic Obstructive Pulmonary Disease.

Abstract

Purpose: Elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) who are hospitalized have a higher incidence of nutritional risk. The geriatric nutritional risk index (GNRI) was applied to evaluate nutritional status in elderly AECOPD patients. Furthermore, its predictive value for 6-month readmission due to acute exacerbations was analyzed.

Patients and methods: A total of 301 elderly AECOPD inpatients admitted to the Department of Respiratory and Critical Care Medicine from March 2023 to June 2024 were included. The demographic, clinical characteristics, smoking history, comorbidities, laboratory values, outcomes of all patients were collected. Evaluate the nutritional risk of patients using GNRI. Multivariate logistic regression model analysis was used to identify the influencing factors of readmission within 6-months.

Results: According to the GNRI, 180 subjects (59.80%) had nutritional risk (GNRI ≤ 98). The readmission rate within 6-months was 32.56%. Single-factor logistic regression analysis showed that GNRI, Sex, BMI, length of hospital stay, heart failure, smoking and GOLD were significantly related to readmission within 6-months (p <0.05). Multivariate logistic regression analysis showed that the risk factors for readmission within 6- months included GNRI (OR = 2.439, p = 0.003, 95% CI: 1.348-4.413), Current smoking (OR = 8.297, p < 0.001, 95% CI: 4.158-16.557), GOLD II (OR = 4.045, p = 0.015, 95% CI: 1.316-12.435), GOLD III (OR = 5.725, p = 0.002, 95% CI: 1.878-17.451), and GOLD IV (OR = 19.063, p < 0.001, 95% CI: 4.504-80.674).

Conclusion: The proportion of nutritional risk was higher in elderly AECOPD inpatients, and GNRI (GNRI ≤ 98) is an independent risk factor for readmission due to acute exacerbations within 6-months.