1.
Geriatric Nutritional Risk Index Predicts Adverse Outcomes in Human Malignancy: A Meta-Analysis.
Lv, GY, An, L, Sun, DW
Disease markers. 2019;:4796598
Abstract
BACKGROUND Geriatric Nutritional Risk Index (GNRI) has been widely used to assess the nutritional status in a variety of human pathological conditions, but the prognostic value of the GNRI in malignancies has not been evinced. METHODS Relevant studies updated on Jul 27, 2019, were retrieved in available databases, including PubMed, Web of Science, Cochrane library, Chinese CNKI, and Chinese Wan-fang. Hazard ratios (HRs) and 95% confidence intervals (CIs) were extracted and pooled by using STATA 14. RESULTS A total of 15 studies involving 8,046 subjects were included in this meta-analysis. Meta-analysis results evinced that low GNRI was associated with poor OS (HR = 1.95, 95% CI: 1.49-2.56, p ≤ 0.001), poor CSS (HR = 1.81, 95% CI: 1.49-2.19, p ≤ 0.001), poor DFS (HR = 1.67, 95% CI: 1.28-2.17, p ≤ 0.001), and poor PFS (HR = 1.68, 95% CI: 1.28-2.21, p ≤ 0.001), and the correlation of GNRI with OS was not changed when stratified by possible confounding factors, suggesting that malignancy patients with low GNRI would suffer from reduced survival rate and increased recurrence rate. Moreover, low GNRI was also associated with postoperative complications in malignancies. CONCLUSIONS In summary, GNRI is associated poor prognosis in human malignancies, and GNRI should be used as a predictive indicator of adverse outcomes during malignancy treatment.
2.
Geriatric Nutritional Risk Index as a predictor for mortality: a meta-analysis of observational studies.
Hao, X, Li, D, Zhang, N
Nutrition research (New York, N.Y.). 2019;:8-20
Abstract
The Geriatric Nutritional Risk Index (GNRI) is a valuable simplified tool to predict mortality. However, the results of previous studies are inconsistent and controversial. To summarize the evidence regarding the association of GNRI levels with the risk of all-cause and cardiovascular (CV) mortality, we conducted this meta-analysis. Relevant studies were identified through a systematic electronic literature search. We estimated combined hazard ratios (HRs) to assess the association between GNRI and the risk of mortality by using a meta-analysis method. The Cochrane Q test and the inconsistency statistic were used to assess the between-study heterogeneity. Subgroup analysis and sensitivity analysis were performed. Twenty-six observational studies involving 17 097 participants were identified in this meta-analysis. With the highest category used as the reference group, the lowest-category GNRI was significantly associated with an increased risk of all-cause (HR: 1.32, 95% confidence interval: 1.22-1.43) and CV (HR = 2.10, 95% confidence interval: 1.72-2.57) mortality. Subgroup analyses based on the participant ethnicity, age, and the duration of the follow-up period did not substantially change the main results. In summary, a lower GNRI is associated with an elevated risk of both all-cause and CV mortality. Given the significant heterogeneity among the included studies, further investigations with larger sample sizes are required to confirm the value of the GNRI in predicting mortality and to explore the combined effects of malnutrition and mortality.
3.
Association of Geriatric Nutritional Risk Index with Mortality in Hemodialysis Patients: A Meta-Analysis of Cohort Studies.
Xiong, J, Wang, M, Zhang, Y, Nie, L, He, T, Wang, Y, Huang, Y, Feng, B, Zhang, J, Zhao, J
Kidney & blood pressure research. 2018;(6):1878-1889
Abstract
BACKGROUND/AIMS: Geriatric nutritional risk index (GNRI) was developed as a "nutrition-related" risk index and was reported in different populations as associated with the risk of all-cause and cardiovascular morbidity and mortality. Therefore, GNRI can be used to classify patients according to a risk of complications in relation to conditions associated with protein-energy wasting (PEW). However, not all reports pointed to the prognostic ability of the GNRI. The purpose of this study was to assess the associations of GNRI with mortality in chronic hemodialysis patients. METHODS We electronically searched original articles published in peer-reviewed journals from their inception to September 2018 in The PubMed, Embase, and the Cochrane Library databases. The primary outcome was all-cause and cardiovascular mortality. We pooled unadjusted and adjusted odds ratios (ORs) with 95% confidence intervals (95% CIs) using Review Manager 5.3 software. RESULTS A total of 10,739 patients from 19 cohort studies published from 2010 to 2018 were included. A significant negative association was found between the GNRI and all-cause mortality in patients with chronic hemodialysis (OR, 0.90; 95% CI, 0.84-0.97, p=0.004) (per unit increase) and (OR, 2.15; 95% CI, 1.88-2.46, p<0.00001) (low vs. high GNRI). Moreover, there was also a significant negative association between the GNRI (per unit increase) and cardiovascular events (OR, 0.98; 95% CI, 0.97-1.00, p=0.01), as well as cardiovascular mortality (OR, 0.89; 95% CI, 0.80-0.99, p=0.03). CONCLUSION Our findings supported the hypothesis that the low GNRI is associated with an increased risk of all-cause and cardiovascular mortality in chronic hemodialysis patients. Based on our literature review, GNRI has been found to be an effective tool for identifying patients with nutrition-related risk of all-cause and cardiovascular disease.