The role of Geriatric Nutritional Risk Index in predicting adverse outcomes in patients with bloodstream infections: a retrospective study

Nutritional deficiencies have been associated with the high prevalence of healthcare-associated infections (HAIs), which is particularly severe in elderly patients. The adverse effects of bloodstream infections (BSIs) in elderly patients are severe when they occur. The Geriatric Nutritional Risk Index (GNRI), specifically designed for the elderly, its prediction value of adverse outcomes of BSIs patients remains unclear. We conducted a two-year retrospective study in a large Chinese tertiary hospital, by collecting surveillance data on patients with bloodstream infections (BSI). We utilized descriptive analysis to delineate the demographic and clinical characteristics of BSI patients across different GNRI levels. The relationship between GNRI and adverse outcomes in BSI patients was investigated using logistic regression and restricted cubic spline (RCS) analysis. From 2020 to 2021, a total of 464 patients with BSI were identified. Among them, 203 (43.8%) were no risk, 70 (15.1%) at low risk, 118 (25.4%) at moderate risk and 73 (15.7%) at major risk for nutrition-related complications based on the GNRI classification. Patients whose GNRI at higher risk had higher mortality (P < 0.001). After adjusting for other covariates by multivariate logistic regression analysis, GNRI at major risk (GNRI < 82) [odds ratio (OR): 3.16; 95% confidence interval (CI): 1.52–6.58; P = 0.002] and GNRI at moderate risk (82 to < 92) (OR: 1.91; 95% CI: 1.00-3.62; P = 0.049) were associated with increased risk for mortality in patients with BSI, while GNRI score (per unit increase) had a protective effect (OR: 0.96; 95% CI: 0.94–0.98; P = 0.001). Furthermore, the RCS analysis showed that the risk of mortality decreased as GNRI scores increased and gradually became stable at GNRI scores above 96–98. We first report the prediction value of GNRI for BSIs patients' adverse outcomes by a two-year retrospective cohort study. There is significantly association between GNRI and adverse outcomes in patients with BSI. For those patients with a lower GNRI, clinicians need to provide more timely and rational nutritional intervention. 1. This study determines whether the GNRI is correlated with the prognosis of inpatients with BSIs, potentially enabling the early identification of those at great risk of adverse outcomes and facilitating timely interventions to enhance the prognosis and quality of care. 2. This study is helpful to improve the management of patients with bloodstream infections.