Predictive Value of Geriatric Nutritional Risk Index in Older Adult Cancer Patients

Background & AIMS To compare the association of geriatric nutritional risk index (GNRI) and controlling nutritional status (CONUT) scores with malnutrition, and to study their association with clinical outcomes in older adult cancer patients. Methods This retrospective analysis was conducted on 854 older adult cancer patients collected from 34 hospitals in 18 cities in China between June and September 2014. Anthropometric and hematological examination results at admission were collected, and subjective global assessment was used. Clinical outcomes, such as complications, length of hospital stays, and hospital costs, were recorded. Receiver operating characteristic curves were used to evaluate the accuracy of the two nutritional assessment tools for malnutrition. The association between GNRI and CONUT score and clinical outcomes was analyzed using the chi-square test, t-test, or rank sum test. Results Among 854 patients with cancer, the prevalence of malnutrition was 42.7%. Compared with subjective global assessment, the GNRI had a significantly higher accuracy than the CONUT score in predicting malnutrition (area under the curve 0.704, 95% confidence interval, 0.658-0.750, P < 0.001). The GNRI was significantly associated with the occurrence of complications (chi 2 = 4.985, P = 0.026), and low GNRI (<= 98) was associated with a longer length of hospital stay (t = -2.179, P = 0.030). Conclusions The GNRI may be used to assess malnutrition in older adult cancer patients and can predict poor clinical outcomes in these patients.