ABSTRACT
Background/Objectives : The clinical characteristics and
prognostic factors of aspiration pneumonia remain poorly defined.
Geriatric nutrition risk index (GNRI) has recently been reported to
exhibit a prognostic value for several diseases in older adults. Thus,
we aimed to investigate the clinical characteristics and prognostic
significance of GNRI for aspiration pneumonia in a sample of older adult
patients.
Design: Retrospective observational cohort study.
Setting: Single-institute acute-phase community hospital.
Participants: Patients with aspiration pneumonia diagnosed at
our institute between April 2014 and March 2016.
Measurements : Data on patient characteristics, microbiological
findings, and clinical course were extracted from electronic medical
records. The primary outcome was in-hospital mortality. Receiver
operating characteristic curve (ROC) analysis was conducted to compare
the predictive value of each parameter. Logistic regression analysis was
performed to identify independent prognostic factors.
Results : Overall, 587 patients with aspiration pneumonia aged ≥
65 years were enrolled. The mean age was 86 years. Among the patients,
97 patients (16.5%) died. ROC analysis for in-hospital mortality
revealed that GNRI had a greater area under the curve value than
albumin, body mass index, and A-DROP score, with a significant
difference between GNRI and albumin (p=0.0058). Male sex (odds ratio
[OR]: 1.88, p = 0.028), chronic heart failure (OR: 2.14, p = 0.023),
history of malignancy (OR: 2.66, p = 0.0025), lower GNRI (OR: 0.94, p
< 0.001), and initial antibiotic change (OR: 4.22, p
< 0.001) were identified as independent adverse prognostic
factors in the multivariate analysis.
Conclusion : Our findings indicate that GNRI is a potential
prognostic marker for older adults with aspiration pneumonia and may act
as a proxy for disease severity. Our results support the use of GNRI in
the clinical management of aspiration pneumonia.