Geriatric Nutritional Risk Index and In-Hospital Mortality in Older Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention: A Retrospective Cohort Study

Abstract

Malnutrition may contribute to adverse outcomes after acute myocardial infarction (AMI), particularly in older patients, but evidence regarding the Geriatric Nutritional Risk Index (GNRI) and in-hospital mortality after percutaneous coronary intervention (PCI) remains limited. This retrospective cohort study evaluated the association between GNRI and in-hospital mortality among 119 patients aged ≥60 years with AMI who underwent PCI at a tertiary referral hospital in Indonesia between January 2023 and December 2025. GNRI was calculated from serum albumin and body weight relative to ideal body weight. The primary outcome was in-hospital all-cause mortality. Survivors and non-survivors were compared using appropriate nonparametric and categorical tests, and binary logistic regression was used to estimate the association between continuous GNRI and mortality. Sixteen patients (13.4%) died during hospitalization. Median GNRI was significantly lower among non-survivors than survivors [84.88 (76.70–94.93) vs 93.82 (86.37–96.79); p=0.029]. Major nutritional risk was present in 37.5% of non-survivors compared with 9.7% of survivors. Higher GNRI was associated with lower odds of in-hospital mortality in crude analysis (OR 0.904, 95% CI 0.844–0.968; p=0.004) and after adjustment for age and multivessel disease (aOR 0.911, 95% CI 0.849–0.977; p=0.009). Lower GNRI was associated with greater in-hospital mortality, supporting its potential utility as a readily available marker of nutritional vulnerability in older patients with AMI undergoing PCI.