Nutritional Risk Index (NRI)
Objective nutritional assessment tool using serum albumin and actual versus usual body weight. NRI = (1.519 × serum albumin g/L) + (41.7 × [current weight / usual weight]). Identifies nutritional risk in hospitalised patients, particularly elderly.
Score interpretation
NRI >100 — no significant nutritional risk
→ Routine nutritional care; ensure adequate protein and caloric intake; reassess if clinical condition changes; regular weight monitoring in hospitalised patients
NRI 97.5–100 — mild nutritional risk
→ Nutritional supplementation consideration; dietary review; increase caloric density of meals; protein target 1.0–1.2 g/kg/day; dietitian referral if not improving; weekly weight; reassess albumin in 2 weeks
NRI 83.5–97.4 — moderate malnutrition risk
→ Dietitian referral; oral nutritional supplements (ONS); protein target 1.2–1.5 g/kg/day; monitor weight twice weekly; reassess albumin weekly; enteral nutrition consideration if oral intake inadequate; document nutritional care plan; review medications affecting appetite
NRI <83.5 — severe malnutrition
→ Urgent dietitian referral; consider enteral (NG/PEG) or parenteral nutrition; protein target >1.5 g/kg; correct electrolyte deficiencies; refeeding syndrome risk — monitor phosphate, potassium, magnesium carefully; daily weights; multidisciplinary nutrition support team; nutritional care plan documentation
Interpretation bands for the NRI. Apply clinical judgement and local guidance.
References
- The Veterans Affairs Total Parenteral Nutrition Cooperative Study Group. Perioperative total parenteral nutrition in surgical patients. N Engl J Med. 1991;325(8):525–532.
Related
Curated clinical cross-links plus same-class fallbacks.
- Vitamins with minerals and trace elements · Parenteral nutrition supplement
- Enteral feeds · Nutritional support
- Dairy products · Nutritional source (calcium, protein, vitamin D)
- Albumin solution · Plasma derivative / colloid
- Parenteral nutrition supplements · Parenteral nutrition
- Palivizumab · RSV Prophylaxis — Monthly Monoclonal Antibody (High-Risk Infants)
- Falls Assessment in Older Adults · NICE CG161 2013
- Delirium Outside ICU · NICE CG103
- Comprehensive Geriatric Assessment (CGA) · BGS / NICE
- Delirium Assessment and Management · NICE CG103 2010
- Frailty Recognition and Management · BGS Frailty Framework / NHS NHSE
- Polypharmacy and Medicines Optimisation · STOPP/START v2 2014 / NICE NG5
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.