BACKGROUND: The number of patients with osteoporotic fractures (OPFs) is on the rise because of global aging. However, few studies have examined the connection between Geriatric Nutritional Risk Index (GNRI) and overall mortality among inpatients with OPFs. Thus, our research seeks to investigate the link between GNRI and overall mortality in inpatients with OPFs. METHODS: A retrospective cohort study was investigated on 3143 Kunshan OPFs residents aged ≥ 50 years. Participants were stratified into malnutrition (GNRI ≤ 98) and no malnutrition groups (GNRI >
98). Multivariate Cox regression analyses were utilized to evaluate the connection between GNRI and overall mortality. No non-linear association was detected through smoothed curve fitting and threshold analysis. Kaplan-Meier curves were employed to compare the cumulative risk of mortality across varying nutritional conditions. Subgroup analyses were conducted to further investigate the effects of age, sex and other clinical and laboratory factors on the link between GNRI and mortality. RESULTS: 3,143 qualified inpatients with OPFs were involved in the final evaluation. Kaplan-Meier curves revealed that the cumulative risk of mortality was markedly elevated in malnutrition group compared to no malnutrition group. In complete adjustments model, malnutrition group showed an adjusted hazard ratio (aHR) of 1.42 [95% CI 1.05, 1.90
P-value = 0.021]. Furthermore, subgroup analyses revealed that no substantial interactions were detected among all variables. (P-interaction >
0.05). CONCLUSIONS: Reduced GNRI scores are linked to higher mortality in inpatients with OPFs. The GNRI potentially serve as a predictor for overall mortality risk in this population.