Tsukasa Saito, MD, PhD, Masafumi Kamachi, MD
Jpn J Compr Rehabil Sci 15: 71-78, 2024
Objective: In this study, we aimed to investigate changes
in the Geriatric Nutritional Risk Index (GNRI), a
nutrition-related prognostic indicator, in our convalescent
rehabilitation ward and determine how this index relates
to activities of daily living (ADL) ability at discharge.
Methods: We retrospectively analyzed data of 107
patients admitted to our convalescent rehabilitation
ward between April and September 2023. We used the
GNRI as the nutritional risk index and Functional
Independence Measure (FIM) as the ADL index.
Results: The patients' mean age was 80.0 +- 10.3
years; 38 were males and 69 females. The patients'
mean body weight at admission was 51.2 +- 10.2 kg,
which significantly decreased to 50.2 +- 9.4 kg at
discharge (p = 0.0006). Their mean body mass index
(BMI) also significantly decreased from 21.4 +- 3.4 at
admission to 20.0 +- 8.2 at discharge (p = 0.002). The
mean GNRI significantly decreased from 93.1 +- 8.6 at
admission to 91.7 +- 8.4 at discharge (p = 0.023). The
mean body weight decreased until the fourth month
after admission; however, no decreasing trend after
the fifth month was observed. The mean monthly
energy intake gradually increased after admission and
reached the calculated energy requirement of 1,415 +-
22 kcal at the fifth month. Multivariate analysis
demonstrated that at discharge, the GNRI score was
positively associated with the FIM score (B = 0.21, p =
0.0008).
Conclusion: Body weight and GNRI scores decreased
after admission but stopped decreasing after the fifth
month due to a gradual increase in energy intake. At
discharge, the FIM score was positively associated with
the GNRI score. We expected that active nutritional
therapy from the beginning of hospitalization would
increase the GNRI by the time of discharge and eventually
improve ADL ability at discharge.
Key words: undernutrition, GNRI, convalescent rehabilitation, FIM, rehabilitative nutrition