Nutrition Assessment as a Predictor of Clinical Outcomes for Infants With Cardiac Surgery: Using the Prognostic Nutritional Index

Background: The nutritional status of the patient is an important parameter in patients undergoing surgery. This study aims to determine of prognostic nutritional index value that predicts hospital mortality and morbidity in on-pump cardiac surgery. Methods: In this study, we scanned the medical data of 1003 patients who underwent on-pump cardiac surgery. Patients’ divided into two groups according to in-hospital mortality. 934 patients without in-hospital mortality were defined as Group I, and 69 patients who died in the hospital were defined as Group II. Their preoperative nutritional status was determined using the prognostic nutritional index classification. Results: In our series, age is statistically higher in Group II rather than Group I (62.5 ± 0.3 vs. 67.4 ± 1.2; p=0.001). There was a significantly different a higher tendency of hospital-acquired infection in Group II (151; 16.2% vs. 44; 63.8%; p=0.001). Postoperative stroke significantly higher in Group II (35; 3.7% vs. 62; 89.9%; p=0.001). Multivariate analysis revealed that cross clamp time, cardiopulmonary bypass time, intraaortic balloon pump usage and intensive care unit stay significantly higher in Group II (p<0.05, respectively). The prognostic nutritional index value was found statistically low in Group II (48.34 ± 6.71 vs. 44.76 ± 7.63; p=0.001). Multivariate analysis revealed that male gender, age, and the prognostic nutritional index were independently associated with postoperative survival. Conclusion: In on-pump cardiac surgery, postoperative mortality and morbidity are significantly associated with preoperative low prognostic nutritional index, and the prognostic nutritional index can be a useful and suitable parameter for preoperative risk evaluation.

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Prognostic nutritional index is an independent prognostic factor for older patients aged ≥ 85 years treated by gastric endoscopic submucosal dissection

BMC Gastroenterology ◽

10.1186/s12876-021-01896-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yosuke Toya ◽

Masaki Endo ◽

Risaburo Akasaka ◽

Toshifumi Morishita ◽

Shunichi Yanai ◽

...

Keyword(s):

Gastric Cancer ◽

Prognostic Factors ◽

Prognostic Factor ◽

Endoscopic Submucosal Dissection ◽

Clinical Outcomes ◽

Older Patients ◽

Prognostic Nutritional Index ◽

Independent Prognostic Factor ◽

Submucosal Dissection ◽

Nutritional Index

Abstract Background Clinical outcomes and prognostic factors for survival after endoscopic submucosal dissection (ESD) in older patients aged ≥ 85 years with early gastric cancer (EGC) are not well defined. The aim of this study was to investigate the clinical outcomes and prognostic factors for survival after ESD in older patients aged ≥ 85 years with EGC. Methods Clinical outcomes of 70 patients aged ≥ 85 years with EGC treated with ESD were evaluated retrospectively. Prognostic factors for overall survival (OS) were analyzed with the Kaplan–Meier method and a Cox proportional hazards model. Results During the follow-up period, 33 patients died from any cause, none of whom died from gastric cancer. OS probability after 3 years was 90.0%. Univariate analyses revealed that a neutrophil/lymphocyte ratio ≥ 2.6, a prognostic nutritional index (PNI) < 42.5 and low serum albumin value (< 3.5 g/dl) were associated with poor OS. Cox multivariate analysis revealed low PNI (< 42.5) to be an independent prognostic factor associated with OS (hazard ratio; 3.40, 95% confidence interval; 1.47–7.86, P = 0.004). Conclusions PNI may be a useful parameter for making the decision to perform ESD for older patients aged ≥ 85 years with EGC.

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