Nutritional risk as predictor for healthcare-associated infection among hospitalized elderly patients in the acute care setting

Summary Background Poor nutritional status is associated with high rates of healthcare-associated infections (HCAIs) among hospitalized elderly patients. Early recognition of patients at risk for HCAIs is important. The Geriatric Nutritional Risk Index (GNRI) is a screening tool able to predict nutr...

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Published in:The Journal of hospital infection 2012-02, Vol.80 (2), p.168-172
Main Authors: Gamaletsou, M.N, Poulia, K.-A, Karageorgou, D, Yannakoulia, M, Ziakas, P.D, Zampelas, A, Sipsas, N.V
Format: Article
Language:English
Subjects:
Acute Disease - therapy
Aged
Aged, 80 and over
Biological and medical sciences
Critical Care - methods
Cross Infection - epidemiology
Elderly
Female
General aspects
Healthcare-associated infection
Human infectious diseases. Experimental studies and models
Humans
Infectious Disease
Infectious diseases
Male
Malnutrition
Medical sciences
Metabolic diseases
Nutrition Assessment
Nutritional Status
Other nutritional diseases (malnutrition, nutritional and vitamin deficiencies...)
Risk Assessment
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Summary:Summary Background Poor nutritional status is associated with high rates of healthcare-associated infections (HCAIs) among hospitalized elderly patients. Early recognition of patients at risk for HCAIs is important. The Geriatric Nutritional Risk Index (GNRI) is a screening tool able to predict nutrition-related complications. Aim To examine the use of GNRI as a predictor of HCAIs in the acute care setting. Methods A total of 248 consecutive patients aged >65 years, admitted as emergencies to the medical ward of an acute care hospital, were enrolled. On admission, clinical and laboratory assessment, anthropometric measurements, performance status, and GNRI score estimation were performed. HCAIs were recorded during admission. Findings On admission, 53.8% of the patients were not at risk, 37.2% at low or medium risk and 8.9% at high risk for nutrition-related complications, as stratified by using the GNRI. During hospitalization 23.7% of the patients developed HCAIs. Patients with HCAIs had higher mortality ( P < 0.001) and longer hospital stay ( P < 0.001). In multivariate analysis, a performance status >1 [hazard ratio (HR): 2.08; 95% confidence interval (CI): 1.07–4.02; P  = 0.03] and diabetes (HR: 2.57; 95% CI: 1.37–4.84; P = 0.003) were associated with increased risk for HCAIs, whereas GNRI score (per unit increase) had a protective effect (HR: 0.97; 95% CI: 0.95–0.99; P = 0.01). Well-nourished patients (GNRI >98) were significantly more likely to remain free from HCAIs during hospitalization ( P  = 0.003). Conclusion GNRI can accurately stratify hospitalized elderly patients according to risk for developing HCAIs.
ISSN:0195-6701
1532-2939
DOI:10.1016/j.jhin.2011.08.020