Controlling nutritional status score and geriatric nutritional risk index as a predictor of mortality and hospitalization risk in hospitalized older adults

Background: The COntrolling NUTritional Status (CONUT) score and the Global Nutrition Risk Index (GNRI) are screening tools for assessing the risk of malnutrition based on widely available biochemical parameters. The primary objective of this study was to investigate the predictive value of CONUT and GNRI score on 36 months mortality and hospitalization risk in hospitalized older patients. Methods: Data of 382 patients (196 women, mean age 80.9±6.8 years) were retrieved from the multicenter Italian Study conducted by the Gruppo Lavoro Italiano Sarcopenia–Trattamento e Nutrizione (GLISTEN) in 12 Acute Care Wards. Sarcopenia was defined as presence of low handgrip strength plus low skeletal mass index (EWGSOP2 criteria). CONUT score was calculated based on serum albumin, total cholesterol and total lymphocyte count, whilst the GNRI was calculated using serum albumin and present body weight/ideal body weight ratio. Results: During the 36-month follow-up, 120 out of 382 participants died (31.4%). From the results of the survival analysis, and after adjustment for potential confounders, participants with CONUT-derived moderate to high risk of malnutrition had shorter survival (HR = 2.67, 95%CI 1.34–5.33 and HR = 3.98, 95% CI: 1.77–8.97, respectively), as well as shorter survival free of urgent hospitalization (HR = 1.91; 95% CI: 1.03–3.55 and HR = 1.98; 95% CI: 1.14–3.42, respectively). Conversely, only GNRI indicative of high risk of malnutrition was an independent predictor of mortality 1.96 (95% CI: 1.06–3.62), but not of hospitalization. Conclusion: The CONUT score seems a valid tool to predict long-term mortality and hospitalization risk. Conversely, the GNRI is associated with long-term mortality, but not with hospital readmissions.