Association Between Geriatric Nutritional Risk Index and the Progression of Chronic Critical Illness and Short-term Prognosis in Sepsis Patients.

IF 2.9 3区医学 Q2 CRITICAL CARE MEDICINE

SHOCK Pub Date : 2025-09-09 DOI:10.1097/SHK.0000000000002711

Chaowei Wang, Zhiyuan Zhang, Jiangui Wang, Chenghua Wang, Zixin Luo, Jianhua Li, Kang Zou, Qinglin Xu

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引用次数: 0

Abstract

Background: The impact of nutritional status on the advancement to chronic critical illness (CCI) in sepsis patients is not well understood. This study aimed to explore the connection between the nutritional risk index (GNRI) and the development of CCI.

Methods: We performed a retrospective study utilizing data from 7,380 sepsis patients in the MIMIC-IV database. The patients were categorized into High GNRI (n = 3412) and Low GNRI (n = 3968) groups. CCI was defined as an ICU stay >14 days with persistent organ dysfunction. Statistical analyses included univariate and multivariate logistic regression, Cox regression, and curve fitting.

Results: Among 7,380 patients (59.1% male, median age 66 years), the high GNRI group had lower body weight, albumin levels, and higher incidence of acute kidney injury. GNRI was a significant predictor of CCI progression (OR: 0.99, 95% CI: 0.98-0.99, p<0.001). After adjusting for confounders, the negative correlation remained (adjusted OR: 0.99, 95% CI: 0.98-1.00, p=0.002). A nonlinear relationship was observed, with an inflection point at GNRI 96.616. Subgroup analyses showed more pronounced protective effects in patients <65 years old and those without cancer, chronic kidney disease, or acute kidney injury. GNRI was also negatively associated with 28-day mortality (adjusted OR: 0.94, 95% CI: 0.93-0.96, p<0.001).

Conclusion: GNRI is an independent predictor of CCI progression and 28-day mortality in sepsis patients. Early nutritional assessment and personalized interventions are crucial in critical care settings. Future research should validate these findings in diverse populations and explore targeted nutritional interventions.

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老年营养风险指数与败血症患者慢性危重疾病进展及短期预后的关系

背景：营养状况对脓毒症患者进展为慢性危重症（CCI）的影响尚不清楚。本研究旨在探讨营养风险指数（GNRI）与CCI发展的关系。方法：我们利用MIMIC-IV数据库中7380例败血症患者的数据进行了回顾性研究。将患者分为高GNRI组（n = 3412）和低GNRI组（n = 3968）。CCI被定义为ICU住院14天，伴有持续的器官功能障碍。统计分析包括单因素和多因素logistic回归、Cox回归和曲线拟合。结果：7380例患者中（男性59.1%，中位年龄66岁），高GNRI组体重、白蛋白水平较低，急性肾损伤发生率较高。GNRI是CCI进展的重要预测因子（OR: 0.99, 95% CI: 0.98-0.99）结论：GNRI是脓毒症患者CCI进展和28天死亡率的独立预测因子。在重症监护环境中，早期营养评估和个性化干预至关重要。未来的研究应该在不同的人群中验证这些发现，并探索有针对性的营养干预措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

SHOCK 医学-外科

CiteScore

6.20

自引率

3.20%

发文量

199

审稿时长

1 months

期刊介绍： SHOCK®: Injury, Inflammation, and Sepsis: Laboratory and Clinical Approaches includes studies of novel therapeutic approaches, such as immunomodulation, gene therapy, nutrition, and others. The mission of the Journal is to foster and promote multidisciplinary studies, both experimental and clinical in nature, that critically examine the etiology, mechanisms and novel therapeutics of shock-related pathophysiological conditions. Its purpose is to excel as a vehicle for timely publication in the areas of basic and clinical studies of shock, trauma, sepsis, inflammation, ischemia, and related pathobiological states, with particular emphasis on the biologic mechanisms that determine the response to such injury. Making such information available will ultimately facilitate improved care of the traumatized or septic individual.