Nutritional Risk
Index Calculator.
Five validated nutritional indices in one clinical tool β Classic NRI Β· Geriatric NRI Β· Prognostic Nutritional Index Β· CONUT Β· PINI β with serial trend tracking, ICU NUTRIC score, weight-loss staging, and evidence-based intervention matrix.
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Clinical Nutrition
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Expert clinical dietitian assessment β personalised nutrition support plan, enteral formula selection, feeding route decision, and outcome monitoring.
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Frequently Asked Questions β Nutritional Risk Index
What is the Nutritional Risk Index (NRI)?
The Nutritional Risk Index (NRI) is a validated bedside formula developed by Buzby et al. (Am J Clin Nutr 1988) from the VA Cooperative Study (n=395) β the only nutritional index validated in a large randomised controlled trial to predict surgical complications and mortality. NRI = 15.19 Γ albumin (g/dL) + 41.7 Γ (current weight / usual weight). Scores above 100 indicate no nutritional risk; below 83.5 indicates severe risk.
What's the difference between NRI and GNRI?
Classic NRI uses the patient's own usual (pre-illness) weight as the reference point, while GNRI (Geriatric Nutritional Risk Index, Bouillanne et al. 2005) uses ideal body weight (Lorentz formula) instead β making it more reliable in elderly patients who may not have a clear recent usual-weight history. GNRI is preferred for patients aged 65 and older.
Why is the current-to-ideal-weight ratio capped at 1.0 in GNRI?
Bouillanne et al. (2005) capped the weight ratio at 1.0 specifically so overweight or obese elderly patients are not scored as falsely low-risk. Without the cap, a patient whose weight exceeds their ideal body weight would inflate the GNRI score, potentially masking real malnutrition β exactly the population GNRI is designed to catch.
What does a low NRI score mean clinically?
NRI <83.5 (severe risk) was associated in the original VA Cooperative Study with a 3-fold increase in major surgical complications and a significant increase in 90-day mortality. ESPEN 2021 recommends initiating enteral nutrition within 24β48 hours, targeting 1.2β1.5 g protein/kg/day and 25β30 kcal/kg/day, with refeeding syndrome screening.
How is the NUTRIC score used alongside NRI?
NUTRIC (Heyland et al. 2011) is a separate ICU-specific tool combining age, APACHE II, SOFA, comorbidities, days from hospital to ICU admission, and optionally IL-6, to identify critically ill patients who benefit most from early aggressive nutrition support. A NUTRIC score of 5 or more (6 or more with IL-6) indicates high risk.
How often should NRI be reassessed?
Serial monitoring is recommended: every 2β7 days in acute hospital settings, every 1β2 weeks in rehabilitation/step-down care, and monthly for stable outpatients (ESPEN 2021). An improvement of more than 3.5 NRI points per week generally confirms adequate nutrition support response.
βοΈ For clinical decision support only β not a substitute for full nutritional assessment by a qualified dietitian. Albumin is an acute-phase reactant and falls during inflammation independent of nutritional status β always interpret NRI alongside clinical context, CRP, and weight history. GNRI preferred in elderly patients. PNI validated in oncology and GI surgery settings. NUTRIC Score requires ICU admission context. Buzby 1988 Β· Bouillanne 2005 Β· ESPEN 2021.