GNRI and Influence of Nutrition on the Mortality of Trauma Patients

Using the Geriatric Nutritional Risk Index (GNRI) to Evaluate the Influence of Nutrition on the Mortality of Trauma Patients

The geriatric nutritional risk index (GNRI) is a simple and efficient tool to assess the nutritional status of patients with malignancies or after surgery. Because trauma patients constitute a specific population that generally acquires accidental and acute injury, this study aimed to identify the association between the GNRI at admission and mortality outcomes of older trauma patients in the intensive care unit (ICU).

Study Overview

• Status: Completed
• Conditions: Trauma Injury
• Intervention / Treatment: Other: Death; Other: Survive

Detailed Description

The nutritional risk index (NRI) is a screening method that was primarily developed to identify older patients with malnutrition. It consists of serum albumin levels as well as body weight measurements. However, even under professional care, the usual body weight is often not documented for older patients. To determine the usual body weight of older patients, the geriatric nutritional risk index (GNRI) was introduced in 2005 by Bouillanne et al - the formula included a combination of serum albumin levels and the ratio of body weight to ideal body weight. The GNRI formula replaces the usual body weight in the NRI formula with the ideal body weight, calculated using the Lorentz formula. Although the GNRI was developed using the data of patients who were admitted to a geriatric rehabilitation care unit, it was found to be a strong prognostic factor for certain malignancies and a simple, objective, and quick method to determine the nutritional status of patients and long-term postoperative outcomes and the correlation between these elements. Using this simple calculation, it is possible to evaluate the nutritional status of critically ill patients with acute respiratory distress syndrome in the intensive care unit (ICU). Considering that trauma patients constitute a specific population, as injuries generally occur accidentally and acutely, it is important to determine whether the GNRI can be used to link nutritional status and outcomes in trauma patients. Therefore, this study aimed to identify the association between GNRI at admission and mortality outcomes of older trauma patients in the ICU.

• Study Type: Observational
• Enrollment (Actual): 700

Contacts and Locations

Study Locations

• Taiwan
  • Kaohsiung, Taiwan, 83301
    • Kaohsiung Chang Gung Memorial Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 63 years to 98 years (Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

The medical records of 39,135 enrolled trauma patients registered between January 1, 2009 and December 31, 2019 were reviewed for this study (Figure 1). The enrolled patients experienced trauma from different injuries and were hospitalized for treatment. Of the 7,136 patients who were admitted to the ICU, 1,926 older trauma patients were aged ≥ 65 years. After excluding patients whose albumin data were not available and those with incomplete data (n = 1,226), 700 older trauma patients were finally included in the study. Detailed information of the study population was extracted from the Trauma Registry System of the hospital.

Description

Inclusion Criteria:

• trauma from different injuries
• hospitalized for treatment
• admitted to the ICU

Exclusion Criteria:

• albumin data were not available
• patients with incomplete data

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Control
• Time Perspectives: Retrospective

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Trauma Patients; The enrolled patients experienced trauma from different injuries and were hospitalized for treatment and admitted to the ICU. 700 older trauma patients (age equal to or more than 65 years) were finally included in the study.	Other: Death; Mortality group; Other: Survive; Survival group

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mortality outcome	Mortality outcome of older trauma patients in the ICU.	through study completion, an average of 1 month

Collaborators and Investigators

• Sponsor: Chang Gung Memorial Hospital

Study record dates

Study Major Dates

• Study Start (Actual): September 7, 2020
• Primary Completion (Actual): September 14, 2020
• Study Completion (Actual): September 20, 2020

Study Registration Dates

• First Submitted: September 21, 2020
• First Submitted That Met QC Criteria: September 26, 2020
• First Posted (Actual): September 29, 2020

Study Record Updates

• Last Update Posted (Actual): September 29, 2020
• Last Update Submitted That Met QC Criteria: September 26, 2020
• Last Verified: September 1, 2020

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Wounds and Injuries
• Other Study ID Numbers: 202001446B0

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No