Relationship of thresholds of physical performance to nutritional status in older hospitalized male cardiac patients

Aim: Nutrition is the focus of a new treatment target in older hospitalized cardiac patients. However, little is known about the differences in nutritional status in relation to physical performance in these inpatients. We determined the differences in physical performance based on the Geriatric Nutritional Risk Index (GNRI) and physical performance cut-off values according to the GNRI in older male cardiac inpatients. Methods: We enrolled 251 Japanese male inpatients aged ≥65 years (mean age 74.7 years) with cardiac disease in the present cross-sectional study. We divided the patients into two groups according to GNRI: high-GNRI group (≥92 points; n=178) and low-GNRI group (<92 points; n=73). In-hospital physical performance as measured by handgrip strength (HG), knee extensor muscle strength (KEMS), gait speed (GS), and one-leg standing time (OLST) was assessed and compared between the two groups to determine cut-off values of physical performance. Results: After adjustment for age, HG, KEMS, GS and OLST were significantly lower in the low-GNRI versus high-GNRI group. Cut-off values by receiver operating characteristic curve analysis were 25.75kgf (area under the curve [AUC]=0.740; P<0.001) for HG strength, 46.1% for bodyweight (AUC=0.742; P<0.01) for KEMS, 1.45m/s (AUC=0.782; P<0.01) for GS and 11.32s (AUC=0.705; P<0.01) for OLST. Conclusion: The risk of poor nutrition, as shown by a low GNRI, could be a useful predictor of physical performance. The cut-off values determined in the present study might be expected minimum target values that can be attained by Japanese older male cardiac inpatients.