Association Between Prognostic Nutrition Index, Geriatric Nutrition Risk Index and 28-Day Mortality in Critically Very Elderly Patients (≥85 Years)

Abstract

Background/Purpose: The aim of this study is to association the Prognostic Nutrition Index(PNI) and Geriatric Nutrition Risk Index(GNRI) with 28-day mortality in critically very elderly patients and compare these indexes with APACHE II and SAPS II scores. Methods: This study is a observational and retrospective study. A total of 189 patients aged 85 years and older who were followed up in the intensive care unit between 2017 and 2021 were included in the study. Demographic data of the patients included in the study, length of stay in the intensive care unit, comorbidities, laboratory data of hospitalization in the intensive care unit, neutrophil/lymphocyte ratios, thrombocyte/lymphocyte ratios, APACHE II, SAPS II, PNI and GNRI index values of intensive care admissions were recorded. Results: In the statistical analysis performed for PNI and GNRI between Survival and Non-survival groups, a statistically significant difference was found between the groups (p=0.022 for PNI, p=0.010 for GNRI). The optimal threshold values of PNI and GNRI were 33.8 and 92.6, respectively. Sensitivity and specificity were 56.1% and 56.9% for PNI, 60.6% and 60.2% for the GNRI. Conclusion: The prognostic nutrition index and geriatric nutrition risk index are associated with 28-day mortality and malnutrition in very elderly patients treated in the intensive care unit. However, these scorings are not as sensitive and specific as APACHE II and SAPS II scores in predicting 28-day mortality.