Association Between the Geriatric Nutritional Risk Index and All-Cause Mortality in Elderly Patients with Acute Ischemic Stroke After Intravenous Thrombolysis

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Background: Malnutrition is related to adverse outcomes across a wide range of diseases. This study aimed to examine the relationship between the Geriatric Nutritional Risk Index (GNRI) and prognosis in elderly patients with acute ischemic stroke (AIS) following intravenous thrombolysis. Methods: This single-center cohort study recruited elderly patients with AIS who received intravenous alteplase thrombolysis, and GNRI was used to evaluate their nutritional status. All-cause mortality was the primary outcome. The relationship between GNRI and prognosis was investigated using Cox proportional hazards models and restricted cubic spline. Results: Three hundred eighteen elderly patients with AIS who underwent intravenous thrombolysis were included and stratified into tertiles based on GNRI. The mean age was 73.05 ± 8.10 years. During a median follow-up of 17.6 months (IQR, 10.8-23.4 months), 38 (12.0%) patients died. Multivariable Cox analysis showed that GNRI (HR 0.944, 95% CI 0.912-0.978, P=0.001) was significantly related to a reduced risk of all-cause death in AIS. T3 group (HR: 0.349; 95% CI: 0.133-0.914, p=0.032) was associated with lower all-cause mortality rates, using T1 group as the reference. Additionally, a linear association between GNRI and all-cause mortality was found using RCS (nonlinear p-value = 0.478). Conclusion: This study found that among older patients with AIS, lower levels of GNRI were linked to all-cause mortality following intravenous thrombolysis.The GNRI could potentially be used to predict all-cause mortality; however, further multicenter studies are needed to confirm the generalizability of these findings.

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