scholarly journals Pre-albumin is a strong prognostic marker in elderly intensive care unit patients

2021 ◽  
Vol 45 (4-5) ◽  
pp. 225-228
Author(s):  
Liyan Luo ◽  
Min Wang
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Risk Index ◽  
Univariate Analysis ◽  
Prognostic Nutritional Index ◽  
Nutritional Risk ◽  
Receiver Operating Curve ◽  
Nutrition Status ◽  
Nutritional Risk Index

Abstract Objectives Pre-albumin (PAB) can be used to evaluate the association between nutrition status and in-hospital mortality. However, there is no literature to compare if PAB is the best indicator to predict in-hospital mortality among the nutrition indexes in a study. Methods We operated a retrospective study including 145 patients admitted to our institution’s elderly intensive care unit (ICU) from January, 2017 to December, 2019. Admission laboratory results were collected. Regression analysis and receiver operating curve (ROC) were analyzed to explore the performance of different nutrition indexes. Results The levels of PAB were significantly different between the survivor and non-survivor group (p=0.001). Univariate analysis showed nutrition indexes (lymphocytes, albumin, body mass index [BMI], geriatric nutritional risk index (GNRI), prognostic nutritional index [PNI] and PAB) were associated with in-hospital mortality (all p<0.1). Following adjustment for age, platelets and creatinine (CREA), only BMI and PAB remained statistically significant (BMI: HR 2.799, 95% CI 1.167–6.715, p=0.021; PAB: HR 6.329, 95% CI 2.660–15.151, p<0.001). In addition, PAB had the highest area under the curve (AUC) for predicting in-hospital mortality (AUC = 0.696) followed by BMI (AUC = 0.561) and other factors. Conclusions PAB is a better predictor of in-hospital mortality than other nutrition indexes in elderly ICU patients.

scholarly journals The Association between Nutritional Status and In-Hospital Mortality of COVID-19 in Critically-Ill Patients in the ICU

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3302
Author(s):  
Michał Czapla ◽  
Raúl Juárez-Vela ◽  
Vicente Gea-Caballero ◽  
Stanisław Zieliński ◽  
Marzena Zielińska
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nutritional Status ◽  
Hospital Mortality ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Invasive Mechanical Ventilation ◽  
Nutritional Risk ◽  
Risk Of Death ◽  
The Impact

Background: Coronavirus disease 2019 (COVID-19) has become one of the leading causes of death worldwide. The impact of poor nutritional status on increased mortality and prolonged ICU (intensive care unit) stay in critically ill patients is well-documented. This study aims to assess how nutritional status and BMI (body mass index) affected in-hospital mortality in critically ill COVID-19 patients Methods: We conducted a retrospective study and analysed medical records of 286 COVID-19 patients admitted to the intensive care unit of the University Clinical Hospital in Wroclaw (Poland). Results: A total of 286 patients were analysed. In the sample group, 8% of patients who died had a BMI within the normal range, 46% were overweight, and 46% were obese. There was a statistically significantly higher death rate in men (73%) and those with BMIs between 25.0–29.9 (p = 0.011). Nonsurvivors had a statistically significantly higher HF (Heart Failure) rate (p = 0.037) and HT (hypertension) rate (p < 0.001). Furthermore, nonsurvivors were statistically significantly older (p < 0.001). The risk of death was higher in overweight patients (HR = 2.13; p = 0.038). Mortality was influenced by higher scores in parameters such as age (HR = 1.03; p = 0.001), NRS2002 (nutritional risk score, HR = 1.18; p = 0.019), PCT (procalcitonin, HR = 1.10; p < 0.001) and potassium level (HR = 1.40; p = 0.023). Conclusions: Being overweight in critically ill COVID-19 patients requiring invasive mechanical ventilation increases their risk of death significantly. Additional factors indicating a higher risk of death include the patient’s age, high PCT, potassium levels, and NRS ≥ 3 measured at the time of admission to the ICU.

Prognostic Value of 3 Nutritional Screening Tools to Predict 30-Day Outcome in Patients Undergoing Carotid Artery Stenting

Angiology ◽  
2021 ◽  
pp. 000331972110403
Author(s):  
Ender Ö Çakmak ◽  
Lütfi Öcal ◽  
Emrah Erdoğan ◽  
Sinan Cerşit ◽  
Süleyman Çağan Efe ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Risk Index ◽  
Predictive Ability ◽  
Prognostic Nutritional Index ◽  
Screening Tools ◽  
Nutritional Risk ◽  
Post Procedure ◽  
Nutritional Risk Index ◽  
Conut Score

The effect of malnutrition on outcomes after carotid artery stenting (CAS) is not well known. This study reports the relationship between malnutrition and post-procedure 30-day major adverse events (MAEs). A total of 978 patients hospitalized for CAS were enrolled in the study. Controlling nutritional status (CONUT) score, the nutritional risk index (NRI), and the prognostic nutritional index (PNI) were calculated. MAEs (myocardial infarction, stroke/transient ischemic attack and mortality) were compared. According to the CONUT score, NRI, and PNI, 9.4%, 41%, and 11.4% patients were moderately or severely malnourished, respectively; 74.8% were at least mildly malnourished by at least 1 score. Forty-seven patients (4.8%) had a post-procedure 30-day MAE. Continuous classifications of the indexes were independently associated with higher MAE. CONUT showed the highest predictive ability, whereas NRI had the lowest (C-index: CONUT, 0.701; NRI, 0.681; PNI, 0.688). According to categorical classification of indexes, only CONUT and PNI showed predictive ability for MAE. Malnutrition assessment could identify patients with CAS at elevated risk for MAE. CONUT, NRI, and PNI continuous scores were independent prognostic factors for the post-procedure 30-day MAE. According to our study, CONUT showed the highest predictive ability.

scholarly journals Geriatric Nutritional Risk Index as a Prognostic Factor in Peritoneal Dialysis Patients

2013 ◽  
Vol 33 (4) ◽  
pp. 405-410 ◽  
Author(s):  
Seok Hui Kang ◽  
Kyu Hyang Cho ◽  
Jong Won Park ◽  
Kyung Woo Yoon ◽  
Jun Young Do
Keyword(s):  
Peritoneal Dialysis ◽  
Prognostic Factor ◽  
Risk Index ◽  
University Hospital ◽  
Nutritional Risk ◽  
Nutrition Status ◽  
Dialysis Patients ◽  
Geriatric Nutritional Risk Index ◽  
Simple Method ◽  
Nutritional Risk Index

BackgroundThe Geriatric Nutritional Risk Index (GNRI) might be a useful screening tool for malnutrition in dialysis patients. However, data concerning the GNRI as a prognostic factor in peritoneal dialysis (PD) patients are scarce.MethodsWe reviewed the medical records at Yeungnam University Hospital in Korea to identify all adults (>18 years) who received PD; 486 patients were enrolled in the study.ResultsThe initial low, middle, and high GNRI tertiles included 162, 166, and 158 patients respectively. Significant correlations were noted between the initial GNRI and body mass index, creatinine, albumin, arm circumference, fat mass index, and comorbidities. The cut-off value for the time-averaged GNRI over 1 year was 96.4, and the sensitivity and specificity for a diagnosis of a decline in lean mass were 77.1% and 40.0% respectively. A multivariate analysis adjusted for age, risk according to the Davies comorbidity index, and C-reactive protein showed that an low initial GNRI tertile was associated with mortality in PD patients.ConclusionsThe GNRI is a simple method for predicting nutrition status and clinical outcome in PD patients.

scholarly journals Nutritional screening based on objective indices at admission predicts in-hospital mortality in patients with COVID-19

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Feier Song ◽  
Huan Ma ◽  
Shouhong Wang ◽  
Tiehe Qin ◽  
Qing Xu ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Hospital Mortality ◽  
Critically Ill ◽  
Risk Index ◽  
Screening Tools ◽  
Nutritional Risk ◽  
Hospital Death ◽  
Nutritional Screening ◽  
Nutritional Risk Index ◽  
Conut Score

Abstract Background Could nutritional status serve as prognostic factors for coronavirus disease 2019 (COVID-19)? The present study evaluated the clinical and nutritional characteristics of COVID-19 patients and explored the relationship between risk for malnutrition at admission and in-hospital mortality. Methods A retrospective, observational study was conducted in two hospitals in Hubei, China. Confirmed cases of COVID-19 were typed as mild/moderate, severe, or critically ill. Clinical data and in-hospital death were collected. The risk for malnutrition was assessed using the geriatric nutritional risk index (GNRI), the prognostic nutritional index (PNI), and the Controlling Nutritional Status (CONUT) via objective parameters at admission. Results Two hundred ninety-five patients were enrolled, including 66 severe patients and 41 critically ill patients. Twenty-five deaths were observed, making 8.47% in the whole population and 37.88% in the critically ill subgroup. Patients had significant differences in nutrition-related parameters and inflammatory biomarkers among three types of disease severity. Patients with lower GNRI and PNI, as well as higher CONUT scores, had a higher risk of in-hospital mortality. The receiver operating characteristic curves demonstrated the good prognostic implication of GNRI and CONUT score. The multivariate logistic regression showed that baseline nutritional status, assessed by GNRI, PNI, or CONUT score, was a prognostic indicator for in-hospital mortality. Conclusions Despite variant screening tools, poor nutritional status was associated with in-hospital death in patients infected with COVID-19. This study highlighted the importance of nutritional screening at admission and the new insight of nutritional monitoring or therapy.

scholarly journals Status gizi pasien bedah mayor preoperasi berpengaruh terhadap penyembuhan luka dan lama rawat inap pascaoperasi di RSUP Dr Sardjito Yogyakarta

2010 ◽  
Vol 7 (1) ◽  
pp. 1
Author(s):  
Susetyowati Susetyowati ◽  
Maya Ija ◽  
Akhmad Makhmudi
Keyword(s):  
Wound Healing ◽  
Length Of Stay ◽  
Risk Index ◽  
Weight Ratio ◽  
Nutritional Risk ◽  
Surgical Patients ◽  
Nutrition Status ◽  
Severe Malnutrition ◽  
Nutritional Risk Index ◽  
Good Nutrition

Background: Severe malnutrition affects morbidity due to disrupted wound healing and decreased endurance against infection. There are some factors that cause malnutrition in surgical patients. Two major factors are lack of food intake and process of inflammation that cause increase of catabolism and decrease of anabolism. The condition can be identified from the decrease of albumin serum and muscle hypothrophy.Objective: The study aimed to identify impact of nutrition status of preoperative major surgical patients based on Nutritional Risk Index (NRI) indicator to wound healing and post operative length of stay.Method: The study was observational with prospective cohort study design. Nutrition screening was undertaken to the group that met inclusion criteria at the preliminary process of hospitalization using NRI indicator to identify nutrition status of surgical patients. Next, the group was split into two, one with undernourished nutrition status and the other with good nutrition status. Assessment of nutrition status of patients was based on NRI obtained from level of serum albumin and current and usual weight ratio within the last 6 months. Weight assessment was made during early hospitalization or weight within the last 6 months.Result: The result of the study showed there was signifiant association between nutrition status and wound healing and post operative length of stay (p<0.05). The result of logistic regression test showed there was impact of nutrition status to wound healing and post operation length of stay. Patients with undernourished nutrition status based on NRI contributed 4.8 times greater for the prevalence of poor wound healing than those with good nutrition status (95%CI: 1.179-19.880). Patients with undernourished nutrition status based on NRI contributed 5.5 times greater for extended length of stay > 7 days than those with good nutrition status (95% CI:4.701-50.914).Conclusion: There was impact of nutrition status of preoperative major surgical patients based on NRI indicator to wound healing and post operative length of stay.

scholarly journals Echocardiogram in critically ill patients with COVID-19

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
B F O Gomes ◽  
T M B Silva ◽  
I R R Menezes ◽  
A S Azevedo ◽  
L S Peres ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Ventricular Dysfunction ◽  
Classification Tree ◽  
Statistical Significance ◽  
Systolic Dysfunction ◽  
Univariate Analysis ◽  
Elevated Serum ◽  
Independent Marker

Abstract Background Describe echocardiographic characteristics in patients admitted to an intensive care unit by COVID-19 and identify clinical and laboratory findings associated with an abnormal echocardiogram and its association with in-hospital mortality. Methods Included all patients with RT-PCR-confirmed COVID-19 who underwent echocardiography during hospitalization. Echocardiographic characteristics were assessed in the entire population and subgroups. We also analyzed clinical characteristics associated with an abnormal echocardiogram. An echocardiogram was defined as abnormal when it demonstrates systolic ventricular dysfunction of any degree (left and/or right ventricle) and/or high filling pressures (E/E' ratio&gt;16; SPAP&gt;40mmHg, RAP&gt;15mmHg or diastolic dysfunction ≥ grade 2) and/or moderate to severe pericardial effusion. Clinical variables were also assessed using a classification tree and binary logistic regression was performed with characteristics that showed a statistical significance in univariate analysis. Finally, echocardiographic variables were assessed for in-hospital mortality outcome using the chi-square test. Results 272 admissions to ICU by COVID-19 were identified. Of these, 159 underwent echocardiography (58.5%). 39 were excluded by incomplete demographic data. 72 echocardiograms (60%) were abnormal according to pre-established criteria. Low occurrence of left and right ventricular systolic dysfunction was observed, as well as 30.8% of the population had a normal diastolic function. In univariate analysis, characteristics associated with abnormal echocardiogram were age, elevated troponin, previous heart failure, and SAPS3 score. In the regression model, troponin was the independent marker of abnormal echocardiography in patients admitted to the intensive care unit by COVID19. This finding was corroborated by the classification tree. The abnormal echocardiogram was not associated with in-hospital mortality (OR 1.60; CI95% 0.75–3.41), but the presence of systolic ventricular dysfunction of any degree was associated with a higher occurrence of this outcome (OR 3.52; CI95% 1.12–11.1). Conclusions In intensive care COVID-19 patients, many manifested elevated ventricular filling pressures, but the occurrence of ventricular dysfunction was low. Elevated serum troponin level was the independent marker associated with an abnormal echocardiogram. Systolic ventricular dysfunction was the only echocardiographic variable associated with in-hospital mortality. FUNDunding Acknowledgement Type of funding sources: None.

Clinical Features of Patients With Heart Failure After the 2016 Kumamoto Earthquakes

2021 ◽  
pp. 1-5
Author(s):  
Yasuhiro Nagayoshi ◽  
Tetsuo Yufu ◽  
Shinzo Miyamoto ◽  
Shinya Yumoto ◽  
Motohiro Hashiyama ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mortality Rate ◽  
Cardiovascular Events ◽  
Clinical Characteristics ◽  
Risk Index ◽  
Prognostic Nutritional Index ◽  
Nutritional Risk ◽  
Acute And Chronic Stress ◽  
The 2016 Kumamoto Earthquakes ◽  
Nutritional Risk Index

Abstract Objective: Acute and chronic stress after severe earthquakes can contribute to cardiovascular events, including heart failure (HF). On April 14, 2016, magnitude 7 earthquakes occurred in the Aso region in the western part of Japan. This study aimed to investigate the clinical characteristics of HF in this area after these earthquakes. Methods: We investigated the clinical characteristics and 1-y mortality rate of patients with HF. Nutritional status was evaluated with the Geriatric Nutritional Risk Index (GNRI) and the Prognostic Nutritional Index (PNI). Results: Among a total of 58 cardiovascular events, HF was the most frequently observed (n = 28). The mean age of individuals with HF was 85.5 y. The total incidence of HF was significantly higher compared with the average of the prior 2 y. Disaster influence on mental health was suggested by patient history in 20 patients (71%). The 1-y mortality rate among patients with HF was 50%. Among those who died, 93% had malnutrition status (GNRI <92 and /or PNI ≤38). Conclusions: Our results demonstrated the poor prognosis of patients with HF following the disaster. The prevalence of malnutrition was high in those patients. Careful follow-up is necessary, especially for older people with frailty.

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