Low (GNRI) is associated with a 1.494 times higher risk of all-cause mortality in elderly patients with .
Participants with low GNRI had a significantly higher risk of cardiovascular mortality, with an adjusted hazard ratio of 1.592.
A nonlinear J-shaped relationship was observed between GNRI and mortality risks, indicating an optimal GNRI around 120.
Subgroup analyses showed consistent associations of low GNRI with increased mortality across various demographic and clinical factors.
The findings suggest that lower GNRI could independently contribute to increased mortality risk in elderly osteoarthritis patients.
Simplified
OBJECTIVE: We intended to investigate the correlation of the (GNRI) and the risks of all-cause and cardiovascular mortality in elderly patients with (OA).
METHODS: This study included 2,922 OA patients aged ≥ 60 years from National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. GNRI was obtained using serum albumin and body weight, with participants stratified into high (≥ 98) and low (< 98) GNRI groups. Cox regressions, survival analysis, and restricted cubic spline (RCS) regression have been utilized to assess mortality risks. Nonlinear threshold effects were evaluated using piecewise regression. Moreover, subgroup analyses have also been completed based on demographic, lifestyle, and clinical features.
RESULTS: Participants with low GNRI had significantly higher risks of all-cause mortality (adjusted HR = 1.494, 95% CI: 1.192-1.872, P < 0.001) and cardiovascular mortality (adjusted HR = 1.592, 95% CI: 1.142-2.219, P = 0.006). RCS analysis presented with a nonlinear J-shaped relationship, with optimal GNRI around 120. Subgroup analyses confirmed consistent associations across age, sex, race, and comorbidity strata.
CONCLUSION: Lower GNRI could independently lead to increased all-cause and cardiovascular mortality in OA patients, highlighting the importance of nutritional assessment in OA management. As a result, GNRI could serve as a valuable prognostic indicator for identifying high-risk individuals who could benefit from targeted nutritional interventions.
Key numbers
1.494
Increase in All-Cause Mortality Risk
Adjusted for low (< 98) vs. high (≥ 98).
1.592
Increase in Cardiovascular Mortality Risk
Adjusted for low (< 98) vs. high (≥ 98).
120
Optimal Threshold
Threshold identified in nonlinear relationship with mortality risk.
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Declarations. Ethics approval and consent to participate: Our research is based on reanalysis of public database, therefore this study is exempt from further ethical review and approval. Consent for publication: All authors approved the final manuscript and the submission to this joumal. Competing interests: The authors declare no competing interests.
