Geriatric nutritional risk index and mortality risk in elderly patients with rheumatoid arthritis: evidence from...

Rheumatoid arthritis (RA) could increase all-cause and cardiovascular mortality, particularly in elderly patients. Malnutrition is usually found in RA and contributes to poorer outcomes, with geriatric nutritional risk index (GNRI) serving as a dependable indicator to provide information on nutritional risk in elderly populations. We aim to elucidate connection between GNRI and survival outcomes in elderly RA patients.

Using NHANES database from 1999-2018, 1,473 RA patients ≥ 60 years old have been chosen. Participants were categorized into High-GNRI and Low-GNRI group with a threshold of 98. Mortal status was extracted from the Linked Mortality Files. Cox regression was utilized to further assess the relationship.

Higher GNRI was significantly associated with lower all-cause (HR 0.563, 95% CI 0.423-0.751, p < 0.001) and cardiovascular mortality (HR 0.571, 95% CI 0.345-0.946, p = 0.030) in fully adjusted models, which was confirmed by Kaplan-Meier survival curves. Subgroup analyses further validated these associations across various demographic and clinical groups.

Higher GNRI is independently associated with a lower risk of all-cause and cardiovascular mortality in elderly RA patients, underscoring the importance of nutritional status in the survival of this population. Key Points • Higher GNRI was significantly associated with lower all-cause and cardiovascular mortality in elderly patients with rheumatoid arthritis. • Restricted cubic spline analysis revealed a linear association, with mortality risk decreasing as GNRI increased.