ESPEN 2012 - Late breaking abstract submission
Topic: Late Breaking Abstract
Abs n°:ESPEN12-1873
Abs Title: PERFORMANCE OF THE GERIATRIC NUTRITIONAL RISK INDEX FOR PREDICTING THE 28-DAY IN-HOSPITAL MORTALITY IN OLDER PATIENTS WITH SEPSIS PRESENTING TO THE EMERGENCY DEPARTMENT
J. S. Lee 1C. W. Hong 1,*O. Y. Kwon 1H. P. Hong 1Y. G. Ko 1
1Department of Emergency Medicine, Kyung Hee University Hospital, Seoul, Korea, Republic Of
Rationale: To evaluate the availability of the Geriatric Nutritional Risk Index (GNRI) for predicting short-term in-hospital mortality in older patients with sepsis who visited the emergency department (ED).
Methods: This was an observational study. Patients aged 65 or older with sepsis who admitted from January, 2010, to May, 2011, in an urban ED were eligible. Demographic, anthropometric, hemodynamic, and laboratory data were collected. The Sequential Organ Failure Assessment (SOFA), the Mortality in Emergency Department Sepsis (MEDS), and the GNRI scores were calculated as originally described. Discrimination of each score was assessed with the area under the receiver operating characteristics curve (AUC). The primary end-point was 28-day in-hospital mortality. To assess independent predictors for mortality with control of co-variables such as age, gender, heart rate, respiratory rate, and severity of illness, we performed multiple logistic regression analysis.
Results: Of 397 patients, 11.8% died. The AUCs of SOFA, MEDS, and GNRI scores were 0.687 (95% CI 0.612–0.763), 0.707 (95% CI 0.631–0.783), and 0.734 (95% CI 0.654–0.813), respectively. Mortality stratified by GNRI was as follows: >98 points, 3.9% (95% CI 0.5–7.2); 92 to 98 points, 9.8% (95% CI 4.3–15.3); 87 to <92 points, 6.9% (95% CI 0.4–13.4); 82 to <87 points, 20.0% (95% CI 8.3–31.7); and <82 points, 34.6% (95% CI 21.7–47.6). After multiple logistic regression analysis, the GNRI was found as an independent predictor of the 28-day in-hospital mortality. Other predictive factors were metastatic cancer, myocardial infarction, hyperthermia, and the SOFA score.
Conclusion: In older patients with sepsis presenting to the ED, the GNRI was a predictive factor for the 28-day in-hospital mortality and performed with better accuracy as compared with SOFA and MEDS scores.
Disclosure of Interest: None Declared
Keywords: GeriatricMortality