Prognostic Nutritional Index and Major Adverse Cardiac Events After Burn Surgery: A Propensity Score Matching Analysis

2021 ◽  
Author(s):  
Hee Yeong Kim ◽  
Jihion Yu ◽  
Yu-Gyeong Kong ◽  
Jun-Young Park ◽  
Donghyeok Shin ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Prognostic Nutritional Index ◽  
Cardiac Events ◽  
Nutritional Index ◽  
Adverse Cardiac Events ◽  
Burn Surgery ◽  
Operating Characteristic Curve

Abstract Burn injuries can cause significant malnutrition, leading to cardiovascular impairments. The prognostic nutritional index (PNI) predicts postoperative complications. We evaluated the impact of preoperative PNI on major adverse cardiac events (MACE) after burn surgery. PNI was calculated using the equation, 10×(serum albumin level)+0.005×(total lymphocyte count). Multivariable logistic regression analysis was conducted to evaluate the predictors for MACE at 6 months after burn surgery. Receiver operating characteristic curve and propensity score matching analyses were conducted. Additionally, Kaplan–Meier analysis was conducted to compare postoperative 1-year mortality between MACE and non-MACE groups. MACE after burn surgery occurred in 184 (17.5%) of 1049 patients. PNI, age, American Society of Anesthesiologists physical status, and TBSA burned were significantly related to MACE. The area under the receiver operating characteristic curve of PNI was 0.729 (optimal cutoff value = 35). After propensity score matching, the incidence of MACE in the PNI <35 group was higher than that in the PNI ≥35 group (20.1% vs 9.6%, P < .001). PNI <35 was related to an increased incidence of MACE (odds ratio = 2.373, 95% confidence interval = 1.499–3.757, P < .001). The postoperative 1-year mortality was higher in the MACE group than in the non-MACE group (54.9% vs 9.1%, P < .001). Preoperative PNI was a predictor for MACE after burn surgery. PNI <35 was significantly related to an increased incidence of MACE. Moreover, MACE was related to higher postoperative 1-year mortality.

scholarly journals Prognostic value of Onodera’s Nutritional Index for intermediate and high risk gastrointestinal stromal tumors treated with or without TKIs

2020 ◽  
Author(s):  
Feng Wang ◽  
Tingting Tao ◽  
Heng Yu ◽  
Yingying Xu ◽  
Xuefeng Xia ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Prognostic Marker ◽  
Prognostic Value ◽  
Prognostic Nutritional Index ◽  
Rank Test ◽  
Lymphocyte Ratio ◽  
Independent Prognostic Marker ◽  
Peripheral Blood Neutrophil ◽  
Nutritional Index

Abstract Background Immunoinflammatory and nutritional markers such as peripheral blood neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and onodera’s prognostic nutritional index (OPNI) have gained considerable attention and revealed preliminaryly as prognostic markers in gastrointestinal stromal tumor (GIST). Methods In this study, we firstly investigated the prognostic value of OPNI in GIST treated with or without TKIs based on the propensity score matching (PSM) method. All of the patients had received surgical resection for primary GIST, The data from 2010 to 2018 were initially and retrospectively identified from our gastrointestinal center. Recurrence-free survival (RFS) was calculated by the Kaplan-Meier method and compared by the log-rank test. Results These patients who were treated with TKIs and those who did not were divided into two groups, and we used propensity score matching method to make them have more unified baseline data. Multivariate Cox proportional hazard regression models were applied to identify associations with outcome variables.A total of 563 GISTs were initially chosen and 280 of them were included for analysis under an inclusion criteria. After PSM, there were 200 patients included. Multivariate analyses identified OPNI was an independent prognostic marker, and was associated with primary site, tumor size, mitotic index, tumor rupture, necrosis, and modified NIH risk classification. Low OPNI (< 44.05; HR 0.433; 95% CI 0.236–0.794; P = 0.007) were associated with worse RFS. Conclusions Preoperative OPNI is a novel and useful prognostic marker for GISTs both treated with or without TKIs.

scholarly journals Prognostic value of Onodera’s Nutritional Index for intermediate and high risk gastrointestinal stromal tumors treated with or without Tyrosine Kinase Inhibitors

2020 ◽  
Author(s):  
Feng Wang ◽  
Tingting Tao ◽  
Heng Yu ◽  
Yingying Xu ◽  
Zhi Yang ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Prognostic Marker ◽  
Prognostic Value ◽  
Kinase Inhibitors ◽  
Prognostic Nutritional Index ◽  
Rank Test ◽  
Lymphocyte Ratio ◽  
Independent Prognostic Marker ◽  
Nutritional Index

Abstract Background Immunoinflammatory and nutritional markers such as peripheral blood neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and onodera’s prognostic nutritional index (OPNI) have gained considerable attention and revealed preliminaryly as prognostic markers in gastrointestinal stromal tumor (GIST). Methods In this study, we firstly investigated the prognostic value of OPNI in GIST treated with or without TKIs based on the propensity score matching (PSM) method. All of the patients had received surgical resection for primary GIST, the data from 2010 to 2018 were initially and retrospectively identified from our gastrointestinal center. Recurrence-free survival (RFS) was calculated by the Kaplan-Meier method and compared by the log-rank test. Results These patients who were treated with TKIs and those who did not were divided into two groups, and we used propensity score matching method to make them have more unified baseline data. Multivariate Cox proportional hazard regression models were applied to identify associations with outcome variables. A total of 563 GISTs were initially chosen and 280 of them were included for analysis under an inclusion criteria. After PSM, there were 200 patients included. Multivariate analyses identified OPNI was an independent prognostic marker, and was associated with primary site, tumor size, mitotic index, tumor rupture, necrosis, and modified NIH risk classification. Low OPNI (< 42.6; HR 0.315; P༜0.001) were associated with worse RFS. Conclusions Preoperative OPNI is a novel and useful prognostic marker for GISTs both treated with or without TKIs.

scholarly journals Association Between Cardiac Enzyme Elevation and Clinical Prognosis of Neurosurgical and Neurocritically Ill Patients

2021 ◽  
Author(s):  
Jung Hwa Lee ◽  
Yun Im Lee ◽  
Joonghyun Ahn ◽  
Jeong-Am Ryu
Keyword(s):  
Propensity Score ◽  
Hospital Mortality ◽  
Propensity Score Matching ◽  
Multivariable Analysis ◽  
Secondary Outcome ◽  
Cardiac Events ◽  
Clinical Prognosis ◽  
Adverse Cardiac Events ◽  
Neurosurgical Patients ◽  
Enzyme Elevation

Abstract To investigate whether cardiac troponin (cTn) elevation is associated with in-hospital mortality and major adverse cardiac events (MACEs) in neurosurgical and neurocritically ill patients. Among neurosurgical patients admitted to the intensive care unit (ICU) from January 2013 to December 2019, those whose serum cTnI levels were obtained within 7 days after ICU admission were included. Propensity score matching was used. Each patient with cTnI elevation was matched to one of control patients. The primary endpoint was in-hospital mortality and the secondary outcome was MACE. cTnI elevation was shown in 702 (11.7%) of 6,004 patients. After propensity score matching, 617 pairs of data were generated by 1:1 individual matching without replacement. In multivariable analysis of overall and propensity score-matched population, cTnI elevation were associated with in-hospital mortality (adjusted odds ratio [OR]: 2.78, 95% confidence interval [CI]: 1.95 – 3.95 and adjusted OR: 1.77, 95% CI: 1.20 – 2.62, respectively). In addition, cTnI elevation were associated with MACE (adjusted OR: 3.75, 95% CI: 2.43 – 5.78 and adjusted OR: 4.04, 95% CI: 2.24 – 7.29, respectively). In this study, cTnI elevation was associated with in-hospital mortality and MACEs in neurosurgical and neurocritically ill patients.

scholarly journals Predictive Value of Prognostic Nutritional Index on COVID-19 Severity

2021 ◽  
Vol 7 ◽  
Author(s):  
Zhong-hua Wang ◽  
Ying-Wen Lin ◽  
Xue-biao Wei ◽  
Fei Li ◽  
Xiao-Long Liao ◽  
...  
Keyword(s):  
Critically Ill ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Multivariate Logistic Regression Analysis ◽  
Prognostic Nutritional Index ◽  
Multivariate Logistic Regression ◽  
Good Discrimination ◽  
Nutritional Index ◽  
Predictive Role

Background: The prognostic nutritional index (PNI) has been described as a simple risk-stratified tool for several diseases. We explored the predictive role of the PNI on coronavirus disease 2019 (COVID-19) severity.Methods: A total of 101 patients with COVID-19 were included in this retrospective study from January 2020 to March 2020. They were divided into two groups according to COVID-19 severity: non-critical (n = 56) and critical (n = 45). The PNI was calculated upon hospital admission: 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (/mm3). Critical COVID-19 was defined as having one of the following features: respiratory failure necessitating mechanical ventilation; shock; organ dysfunction necessitating admission to the intensive care unit (ICU). The correlation between the PNI with COVID-19 severity was analyzed.Results: The PNI was significantly lower in critically ill than that in non-critically ill patients (P &lt; 0.001). The receiver operating characteristic curve indicated that the PNI was a good discrimination factor for identifying COVID-19 severity (P &lt; 0.001). Multivariate logistic regression analysis showed the PNI to be an independent risk factor for critical illness due to COVID-19 (P = 0.002).Conclusions: The PNI is a valuable biomarker that could be used to discriminate COVID-19 severity.

scholarly journals Prognostic value of Onodera’s Nutritional Index for intermediate and high risk gastrointestinal stromal tumors treated with or without Tyrosine Kinase Inhibitors

2021 ◽  
Author(s):  
Feng Wang ◽  
Tingting Tao ◽  
Heng Yu ◽  
Yingying Xu ◽  
Zhi Yang ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Prognostic Marker ◽  
Prognostic Value ◽  
Kinase Inhibitors ◽  
Prognostic Nutritional Index ◽  
Rank Test ◽  
Lymphocyte Ratio ◽  
Independent Prognostic Marker ◽  
Nutritional Index

Abstract Background Immunoinflammatory and nutritional markers such as peripheral blood neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and onodera’s prognostic nutritional index (OPNI) have gained considerable attention and revealed preliminaryly as prognostic markers in gastrointestinal stromal tumor (GIST). Methods In this study, we firstly investigated the prognostic value of OPNI in GIST treated with or without TKIs based on the propensity score matching (PSM) method. All of the patients had received surgical resection for primary GIST, the data from 2010 to 2018 were initially and retrospectively identified from our gastrointestinal center. Recurrence-free survival (RFS) was calculated by the Kaplan-Meier method and compared by the log-rank test. Results These patients who were treated with TKIs and those who did not were divided into two groups, and we used propensity score matching method to make them have more unified baseline data. Multivariate Cox proportional hazard regression models were applied to identify associations with outcome variables. A total of 563 GISTs were initially chosen and 280 of them were included for analysis under an inclusion criteria. After PSM, there were 200 patients included. Multivariate analyses identified OPNI was an independent prognostic marker, and was associated with primary site, tumor size, mitotic index, tumor rupture, necrosis, and modified NIH risk classification. Low OPNI (< 42.6; HR 0.315; P༜0.001) were associated with worse RFS. Conclusions Preoperative OPNI is a novel and useful prognostic marker for GISTs both treated with or without TKIs.

Controlling Nutritional Status score is superior to Prognostic Nutritional Index score in predicting survival and complications in pancreatic ductal adenocarcinoma: a Chinese propensity score matching study

2020 ◽  
Vol 124 (11) ◽  
pp. 1190-1197
Author(s):  
Yi-Shen Mao ◽  
Si-Jie Hao ◽  
Cai-Feng Zou ◽  
Zhi-Bo Xie ◽  
De-Liang Fu
Keyword(s):  
Propensity Score ◽  
Nutritional Status ◽  
Propensity Score Matching ◽  
Prognostic Nutritional Index ◽  
Ductal Adenocarcinoma ◽  
Poor Overall Survival ◽  
Nutritional Index ◽  
Independent Risk Factors ◽  
Baseline Characteristics ◽  
Higher Sensitivity

AbstractPreoperative nutritional status plays an important role in predicting postoperative outcomes. Prognostic Nutritional Index (PNI) and Controlling Nutritional Status (CONUT) are good tools to assess patients’ nutritional status. They have been used in predicting outcomes in various malignancies, but few studies have focused on pancreatic adenocarcinoma (PDAC) patients. Totally, 306 PDAC patients were enrolled. The propensity score matching (PSM) method was introduced to eliminate the baseline inequivalence. Patients with different PNI (or CONUT) scores showed inequivalence baseline characteristics, and patients with compromised nutritional status were related with a more advanced tumour stage. After PSM, the baseline characteristics were well balanced. Both low PNI (≤45) and high CONUT (≥3) were independent risk factors for poor overall survival (P < 0·05), and the result remained the same after PSM. Survival analysis demonstrated both patients with low PNI and high CONUT score were associated with poorer survival, and the result remained the same after PSM. The results of AUC indicated that CONUT might have a higher sensitivity and specificity in predicting complications and survival. Preoperative low PNI (≤45) and high CONUT (≥3) scores might be reliable predictors of prognosis and surgical complications in PDAC patients. Compared with PNI, CONUT might be more effective.

Predictive ability of prognostic nutritional index in surgically resected gastrointestinal stromal tumors: a propensity score matching analysis

2019 ◽  
Vol 49 (9) ◽  
pp. 823-831 ◽  
Author(s):  
Wei-Kun Shi ◽  
Xin-Hua Zhang ◽  
Jian Zhang ◽  
Miao Yu ◽  
Yu-Jie Yuan ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Gastrointestinal Stromal Tumors ◽  
Predictive Ability ◽  
Prognostic Nutritional Index ◽  
Stromal Tumors ◽  
Propensity Score Matching Analysis ◽  
Nutritional Index ◽  
Before And After ◽  
Prognostic Stratification

Prognostic nutritional index was found to be correlated with prognosis in GISTs before and after propensity score matching and its incorporation improved the prognostic stratification of NIH risk criteria.

Association of Polycythemia with Outcomes of Acute Coronary Syndrome

Cardiology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Gil Marcus ◽  
Michael E. Farkouh ◽  
Sa’ar Minha ◽  
Shmuel Fuchs ◽  
Eran Kalmanovich ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Cardiac Events ◽  
Coronary Syndrome ◽  
Increased Risk ◽  
Adverse Cardiac Events ◽  
All Cause Mortality ◽  
Baseline Characteristics

<b><i>Background:</i></b> Polycythemia has not been extensively studied for its impact on acute coronary syndrome (ACS) outcomes. A previous study reported only 30-day outcomes to be worse in these patients. <b><i>Methods:</i></b> Data from the ACS Israeli survey between 2000 and 2018 were utilized to compare between 3 groups of patients with ACS: anemic group (hemoglobin &#x3c;12 g/dL for women and &#x3c;12.5 g/dL for men), normal hemoglobin group, and polycythemic group (&#x3e;16 g/dL and &#x3e;16.5 g/dL, respectively). Measured outcomes included 30-day major adverse cardiac events (MACE comprising all-cause mortality, recurrent ACS, need for urgent revascularization, and stroke) and 1- and 5-year all-cause mortality. <b><i>Results:</i></b> Of 14,746 ACS patients, 10,752 (72.9%) had normal hemoglobin levels, 3,492 (23.7%) were anemic, and 502 (3.4%) were polycythemic. In comparison with normal and anemic patients, polycythemic patients were younger (55.9 ± 10.5 vs. 61.9 ± 12.4 and 71.1 ± 12.2 for anemic, respectively, <i>p</i> &#x3c; 0.001 for both), more frequently men (93.8% vs. 81.3% and 63.1%, respectively, <i>p</i> &#x3c; 0.001), and less likely diabetic or hypertensive. Upon adjustment to baseline characteristics, compared with normal hemoglobin, polycythemia was not independently associated with 30-day MACE or 1-year mortality, but it was independently associated with higher risk for 5-year mortality (HR 1.76, 95% CI: 1.19–2.59, <i>p</i> = 0.005). Similar results were observed after propensity score matching. <b><i>Conclusions:</i></b> Although younger and with fewer comorbidities, polycythemic ACS patients are at increased risk for long-term all-cause mortality. Further study of this association is warranted to understand the causes and possibly to improve the outcomes of these patients.

scholarly journals Association Between Cardiac Enzyme Elevation and Clinical Prognosis of Neurosurgical and Neurocritically Ill Patients

2021 ◽  
Author(s):  
Jung Hwa Lee ◽  
Yun Im Lee ◽  
Joonghyun Ahn ◽  
Jeong-Am Ryu
Keyword(s):  
Propensity Score ◽  
Hospital Mortality ◽  
Propensity Score Matching ◽  
Multivariable Analysis ◽  
Secondary Outcome ◽  
Cardiac Events ◽  
Clinical Prognosis ◽  
Adverse Cardiac Events ◽  
Neurosurgical Patients ◽  
Enzyme Elevation

Abstract To investigate whether cardiac troponin (cTn) elevation is associated with in-hospital mortality and major adverse cardiac events (MACEs) in neurosurgical and neurocritically ill patients. Among neurosurgical patients admitted to the intensive care unit (ICU) from January 2013 to December 2019, those whose serum cTnI levels were obtained within 7 days after ICU admission were included. Propensity score matching was used. Each patient with cTnI elevation was matched to one of control patients. The primary endpoint was in-hospital mortality and the secondary outcome was MACE. cTnI elevation was shown in 702 (11.7%) of 6,004 patients. After propensity score matching, 617 pairs of data were generated by 1:1 individual matching without replacement. In multivariable analysis of overall and propensity score-matched population, cTnI elevation were associated with in-hospital mortality (adjusted odds ratio [OR]: 2.78, 95% confidence interval [CI]: 1.95 – 3.95 and adjusted OR: 1.77, 95% CI: 1.20 – 2.62, respectively). In addition, cTnI elevation were associated with MACE (adjusted OR: 3.75, 95% CI: 2.43 – 5.78 and adjusted OR: 4.04, 95% CI: 2.24 – 7.29, respectively). In this study, cTnI elevation was associated with in-hospital mortality and MACEs in neurosurgical and neurocritically ill patients.

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