Effectiveness of GNRI in assessing malnutrition in elderly patients with chronic obstructive pulmonary disease at stable stage_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

SHAN Xia , YIN Qingqing , SHI Yuting , FEI Fan , WAN Bing ,  ZHANG Xiuwei

Department of Respiratory and Critical Care Medicine, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu 211000, P. R. China;

Corresponding author：

ZHANG Xiuwei, Email: zhangxiuwei@njmu.edu.cn

Keywords：

Chronic obstructive pulmonary disease; Geriatric Nutritional Risk Index; nutritional screening; malnutrition

DOI：

10.7507/1671-6205.202212018

Video：

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Objective To explore the diagnostic efficacy of Geriatric Nutritional Risk Index (GNRI) in malnutrition of elderly patients with chronic obstructive pulmonary disease (COPD) in outpatient department. Methods One hundred and five elderly outpatients with COPD were enrolled in the study, and their nutritional screening was carried out. The clinical and laboratory parameters of patients in the normal nutrition group (high GNRI group) and malnutrition group (low GNRI group) were compared, and the correlation analysis was conducted. The diagnostic efficacy of GNRI was evaluated based on the malnutrition universal screening tool (MUST). Results The prevalence of malnutrition was high in COPD elderly outpatients. The prevalence of malnutrition in group D was 61.8%. There were significant differences between the two groups in body mass index, serum albumin, FEV₁ percentage in the predicted value, 6-minute walk distance, and the number of acute exacerbations in the past year. GNRI was significantly related to the above parameters. The sensitivity, specificity and accuracy of GNRI were 81.8%, 83.6% and 82.9%, using MUST as the standard. Conclusion GNRI can be used for nutritional screening of COPD patients in elderly outpatients, which is simple, convenient and relatively accurate, and can be popularized in other medical institutions.

Citation： SHAN Xia, YIN Qingqing, SHI Yuting, FEI Fan, WAN Bing, ZHANG Xiuwei. Effectiveness of GNRI in assessing malnutrition in elderly patients with chronic obstructive pulmonary disease at stable stage. Chinese Journal of Respiratory and Critical Care Medicine, 2023, 22(10): 692-696. doi: 10.7507/1671-6205.202212018 Copy

1.	Ahmadi A, Eftekhari MH, Mazloom Z, et al. Health-related quality of life and nutritional status are related to dietary magnesium intake in chronic obstructive pulmonary disease: a cross-sectional study. Clin Nutr Res, 2022, 11(1): 62-73.
2.	Sehgal IS, Dhooria S, Agarwal R. Chronic obstructive pulmonary disease and malnutrition in developing countries. Curr Opin Pulm Med, 2017, 23(2): 139-148.
3.	Arslan M, Soylu M, Kanger G, et al. Evaluation of malnutrition detected with the Nutritional Risk Screening 2002 (NRS-2002) and the quality of life in hospitalized patients with chronic obstructive pulmonary disease. Hippokratia, 2016, 20(2): 147-152.
4.	Maia I, Xará S, Dias I, et al. Nutritional screening of pulmonology department inpatients. Rev Port Pneumol, 2014, 20(6): 293-298.
5.	Collins PF, Elia M, Kurukulaaratchy RJ, et al. The influence of deprivation on malnutrition risk in outpatients with chronic obstructive pulmonary disease (COPD). Clin Nutr, 2018, 37(1): 144-148.
6.	Bouillanne O, Morineau G, Dupont C, et al. Geriatric Nutritional Risk Index: a new index for evaluating at-risk elderly medical patients. Am J Clin Nutr, 2005, 82(4): 777-783.
7.	Shen FF, Ma Y, Guo W, et al. Prognostic value of geriatric nutritional risk index for patients with non-small cell lung cancer: a systematic review and meta-analysis. Lung, 2022, 200(5): 661-669.
8.	Minamisawa M, Miura T, Motoki H, et al. Geriatric nutritional risk index predicts cardiovascular events in patients at risk for heart failure. Circ J, 2018, 82(6): 1614-1622.
9.	Sharma Y, Miller M, Kaambwa B, et al. Malnutrition and its association with readmission and death within 7 days and 8-180 days postdischarge in older patients: a prospective observational study. BMJ Open, 2017, 7(11): 018443.
10.	Xie HL, Tang SY, Wei LS, et al. Geriatric nutritional risk index as a predictor of complications and long-term outcomes in patients with gastrointestinal malignancy: a systematic review and meta-analysis. Cancer Cell Int, 2020, 20(1): 530.
11.	Dai CJ, Yan D, Xu MJ, et al. Geriatric Nutritional Risk Index is related to the risk of stroke-associated pneumonia. Brain Behav, 2022, 12(8): e2718.
12.	Fang PH, Yang Q, Zhou JF, et al. The impact of geriatric nutritional risk index on esophageal squamous cell carcinoma patients with neoadjuvant therapy followed by esophagectomy. Front Nutr, 2022, 9: 983038.
13.	Matsumura T, Mitani Y, Oki Y, et al. Comparison of geriatric nutritional risk index scores on physical performance among elderly patients with chronic obstructive pulmonary disease. Heart Lung, 2015, 44(6): 534-538.
14.	Mullen JT, Davenport DL, Hutter MM, et al. Impact of body mass index on perioperative outcomes in patients undergoing major intra-abdominal cancer surgery. Ann Surg Oncol, 2008, 15(8): 2164-2172.
15.	Krzystek-Korpacka M, Matusiewicz M, Diakowska D, et a1. Respiratory insufficiency related to COPD accelerates systemic inflammation, under-nutrition, and angiogenesis in esophageal malignancies. Exp Oncol, 2008, 30(1): 75-80.
16.	常春, 姚婉贞, 方天舒. 慢性阻塞性肺疾病患者死因构成及其生存时间的影响因素. 中华医学杂志, 2011, 91(12): 824-827.
17.	高士媛, 施敏骅, 陈锐, 等. 精简微型营养评价量表预测老年慢性阻塞性肺疾病患者急性加重风险的效能评价. 中华医学杂志, 2020, 100(14): 1063-1067.
18.	陈炼, 朱哲, 马立宇, 等. 去脂体质量指数在稳定期慢性阻塞性肺疾病患者营养不良筛查中的应用及效度评价. 中华老年医学杂志, 2015, 34(4): 387-390.
19.	Battaglia S, Spatafora M, Paglino G, et al. Ageing and COPD affect different domains of nutritional status: the ECCE study. Eur Respir J, 2011, 37(6): 1340-1345.
20.	Günay E, Kaymaz D, Selçuk NT, et al. Effect of nutritional status in individuals with chronic obstructive pulmonary disease undergoing pulmonary rehabilitation. Respirology, 2013, 18(8): 1217-1222.

1. Ahmadi A, Eftekhari MH, Mazloom Z, et al. Health-related quality of life and nutritional status are related to dietary magnesium intake in chronic obstructive pulmonary disease: a cross-sectional study. Clin Nutr Res, 2022, 11(1): 62-73.
2. Sehgal IS, Dhooria S, Agarwal R. Chronic obstructive pulmonary disease and malnutrition in developing countries. Curr Opin Pulm Med, 2017, 23(2): 139-148.
3. Arslan M, Soylu M, Kanger G, et al. Evaluation of malnutrition detected with the Nutritional Risk Screening 2002 (NRS-2002) and the quality of life in hospitalized patients with chronic obstructive pulmonary disease. Hippokratia, 2016, 20(2): 147-152.
4. Maia I, Xará S, Dias I, et al. Nutritional screening of pulmonology department inpatients. Rev Port Pneumol, 2014, 20(6): 293-298.
5. Collins PF, Elia M, Kurukulaaratchy RJ, et al. The influence of deprivation on malnutrition risk in outpatients with chronic obstructive pulmonary disease (COPD). Clin Nutr, 2018, 37(1): 144-148.
6. Bouillanne O, Morineau G, Dupont C, et al. Geriatric Nutritional Risk Index: a new index for evaluating at-risk elderly medical patients. Am J Clin Nutr, 2005, 82(4): 777-783.
7. Shen FF, Ma Y, Guo W, et al. Prognostic value of geriatric nutritional risk index for patients with non-small cell lung cancer: a systematic review and meta-analysis. Lung, 2022, 200(5): 661-669.
8. Minamisawa M, Miura T, Motoki H, et al. Geriatric nutritional risk index predicts cardiovascular events in patients at risk for heart failure. Circ J, 2018, 82(6): 1614-1622.
9. Sharma Y, Miller M, Kaambwa B, et al. Malnutrition and its association with readmission and death within 7 days and 8-180 days postdischarge in older patients: a prospective observational study. BMJ Open, 2017, 7(11): 018443.
10. Xie HL, Tang SY, Wei LS, et al. Geriatric nutritional risk index as a predictor of complications and long-term outcomes in patients with gastrointestinal malignancy: a systematic review and meta-analysis. Cancer Cell Int, 2020, 20(1): 530.
11. Dai CJ, Yan D, Xu MJ, et al. Geriatric Nutritional Risk Index is related to the risk of stroke-associated pneumonia. Brain Behav, 2022, 12(8): e2718.
12. Fang PH, Yang Q, Zhou JF, et al. The impact of geriatric nutritional risk index on esophageal squamous cell carcinoma patients with neoadjuvant therapy followed by esophagectomy. Front Nutr, 2022, 9: 983038.
13. Matsumura T, Mitani Y, Oki Y, et al. Comparison of geriatric nutritional risk index scores on physical performance among elderly patients with chronic obstructive pulmonary disease. Heart Lung, 2015, 44(6): 534-538.
14. Mullen JT, Davenport DL, Hutter MM, et al. Impact of body mass index on perioperative outcomes in patients undergoing major intra-abdominal cancer surgery. Ann Surg Oncol, 2008, 15(8): 2164-2172.
15. Krzystek-Korpacka M, Matusiewicz M, Diakowska D, et a1. Respiratory insufficiency related to COPD accelerates systemic inflammation, under-nutrition, and angiogenesis in esophageal malignancies. Exp Oncol, 2008, 30(1): 75-80.
16. 常春, 姚婉贞, 方天舒. 慢性阻塞性肺疾病患者死因构成及其生存时间的影响因素. 中华医学杂志, 2011, 91(12): 824-827.
17. 高士媛, 施敏骅, 陈锐, 等. 精简微型营养评价量表预测老年慢性阻塞性肺疾病患者急性加重风险的效能评价. 中华医学杂志, 2020, 100(14): 1063-1067.
18. 陈炼, 朱哲, 马立宇, 等. 去脂体质量指数在稳定期慢性阻塞性肺疾病患者营养不良筛查中的应用及效度评价. 中华老年医学杂志, 2015, 34(4): 387-390.
19. Battaglia S, Spatafora M, Paglino G, et al. Ageing and COPD affect different domains of nutritional status: the ECCE study. Eur Respir J, 2011, 37(6): 1340-1345.
20. Günay E, Kaymaz D, Selçuk NT, et al. Effect of nutritional status in individuals with chronic obstructive pulmonary disease undergoing pulmonary rehabilitation. Respirology, 2013, 18(8): 1217-1222.

Chinese Journal of Respiratory and Critical Care Medicine

Effectiveness of GNRI in assessing malnutrition in elderly patients with chronic obstructive pulmonary disease at stable stage

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