scholarly journals Obvious but Always Ignored: Nutritional Status Affects Cardiac Surgery Mortality

2021 ◽  
Author(s):  
Arif Gucu ◽  
Ozlem Arican Ozluk ◽  
Sadik Ahmet Sunbul ◽  
Nail Kahraman ◽  
Deniz Demir ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Cardiac Surgery ◽  
Nutritional Status ◽  
Hospital Mortality ◽  
Prognostic Nutritional Index ◽  
Mortality And Morbidity ◽  
Nutritional Index ◽  
Group I ◽  
Group Ii ◽  
Index Value

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.

scholarly journals Immunonutritive Scoring in Patients With Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization: Prognostic Nutritional Index or Controlling Nutritional Status Score?

2021 ◽  
Vol 11 ◽  
Author(s):  
Lukas Müller ◽  
Felix Hahn ◽  
Aline Mähringer-Kunz ◽  
Fabian Stoehr ◽  
Simon J. Gairing ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Multivariate Analysis ◽  
Prognostic Factor ◽  
Nutritional Status ◽  
Transarterial Chemoembolization ◽  
Predictive Ability ◽  
Prognostic Nutritional Index ◽  
Independent Prognostic Factor ◽  
Nutritional Index ◽  
Conut Score

ObjectivesThe Prognostic Nutritional Index (PNI) and Controlling Nutritional Status (CONUT) score are immunonutritive scoring systems with proven predictive ability in various cancer entities, including hepatocellular carcinoma (HCC). We performed the first evaluation of the CONUT score for patients undergoing transarterial chemoembolization (TACE) and compared CONUT and PNI in the ability to predict median overall survival (OS).MethodsBetween 2010 and 2020, we retrospectively identified 237 treatment-naïve patients with HCC who underwent initial TACE at our institution. Both scores include the albumin level and total lymphocyte count. The CONUT additionally includes the cholesterol level. Both scores were compared in univariate and multivariate regression analyses taking into account established risk factors. In a second step, a subgroup analysis was performed on BCLC stage B patients, for whom TACE is the recommended first-line treatment.ResultsA high CONUT score and low PNI were associated with impaired median OS (8.7 vs. 22.3 months, p&lt;0.001 and 6.8 vs. 20.1 months, p&lt;0.001, respectively). In multivariate analysis, only the PNI remained an independent prognostic predictor (p=0.003), whereas the CONUT score lost its predictive ability (p=0.201). In the subgroup of recommended TACE candidates, both CONUT and PNI were able to stratify patients according to their median OS (6.6 vs. 17.9 months, p&lt;0.001 and 10.3 vs. 22.0 months, p&lt;0.001, respectively). Again, in the multivariate analysis, only the PNI remained an independent prognostic factor (p=0.012).ConclusionBoth scores were able to stratify patients according to their median OS, but only the PNI remained an independent prognostic factor. Therefore, PNI should be preferred when evaluating the nutritional status of patients undergoing TACE.

Preoperative Controlling Nutritional Status Score Predicts Mortality after Hepatectomy for Hepatocellular Carcinoma

2018 ◽  
Vol 36 (3) ◽  
pp. 226-232 ◽  
Author(s):  
Kosei Takagi ◽  
Yuzo Umeda ◽  
Ryuichi Yoshida ◽  
Daisuke Nobuoka ◽  
Takashi Kuise ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Nutritional Status ◽  
Hospital Mortality ◽  
Liver Failure ◽  
Prognostic Nutritional Index ◽  
Preoperative Assessment ◽  
Postoperative Outcomes ◽  
Perioperative Outcomes ◽  
Nutritional Index ◽  
Conut Score

Background: Preoperative nutritional status is reportedly associated with postoperative outcomes in patients with hepatocellular carcinoma. This study aimed to investigate the significance of the controlling nutritional status (CONUT) score and the prognostic nutritional index (PNI) as predictors of postoperative outcomes. Methods: We retrospectively reviewed data from 331 patients who underwent hepatectomy for hepatocellular carcinoma between January 2007 and December 2015. Patients were divided into 2 groups based on their CONUT score and the PNI. We evaluated the effect of the CONUT score and PNI on perioperative outcomes. Multivariate analysis was performed to identify independent predictors of in-hospital mortality after hepatectomy. ­Results: The high CONUT group had a significantly higher ­incidence of 30-day mortality (p < 0.001), in-hospital mortality (p = 0.002), ascites (p = 0.006), liver failure (p = 0.02), sepsis (p = 0.01), and enteritis (p < 0.001). The low PNI group was also significantly associated with 30-day mortality (p < 0.001), in-hospital mortality (p = 0.003), liver failure (p < 0.001), sepsis (p = 0.02), enteritis (p = 0.02), and hospital stay (p = 0.01). In multivariate analyses, a high CONUT score was an independent predictor of in-hospital mortality after hepatectomy (hazard ratio [HR] 9.41, p = 0.038), but the PNI was not (HR 5.86, p = 0.08). Conclusions: Preoperative assessment of the CONUT score is helpful for evaluating patients’ nutritional status and mortality risk after liver surgery.

Preoperative Low Serum Albumin Levels Increase the Requirement of Renal Replacement Therapy after Cardiac Surgery

2016 ◽  
Vol 19 (3) ◽  
pp. 123 ◽  
Author(s):  
Orhan Findik ◽  
Ufuk Aydin ◽  
Ozgur Baris ◽  
Hakan Parlar ◽  
Gokcen Atilboz Alagoz ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Regression Analysis ◽  
Cardiac Surgery ◽  
Renal Replacement Therapy ◽  
Serum Albumin ◽  
Replacement Therapy ◽  
Kidney Injury ◽  
Preoperative Serum ◽  
Group I ◽  
Group Ii

<strong>Background:</strong> Acute kidney injury is a common complication of cardiac surgery that increases morbidity and mortality. The aim of the present study is to analyze the association of preoperative serum albumin levels with acute kidney injury and the requirement of renal replacement therapy after isolated coronary artery bypass graft surgery (CABG).<br /><strong>Methods:</strong> We retrospectively reviewed the prospectively collected data of 530 adult patients who underwent isolated CABG surgery with normal renal function. The perioperative clinical data of the patients included demographic data, laboratory data, length of stay, in-hospital complications and mortality. The patient population was divided into two groups: group I patients with preoperative serum albumin levels &lt;3.5 mg/dL; and group II pateints with preoperative serum albumin levels ≥3.5 mg/dL.<br /><strong>Results:</strong> There were 413 patients in group I and 117 patients in group II. Postoperative acute kidney injury (AKI) occured in 33 patients (28.2%) in group I and in 79 patients (19.1%) in group II. Renal replacement therapy was required in 17 patients (3.2%) (8 patients from group I; 9 patients from group II; P = .018). 30-day mortality occurred in 18 patients (3.4%) (10 patients from group I; 8 patients from group II; P = .037). Fourteen of these patients required renal replacement therapy. Logistic regression analysis revealing the presence of lower serum albumin levels preoperatively was shown to be associated with increased incidence of postoperative AKI (OR: 1.661; 95% CI: 1.037-2.661; <br />P = .035). Logistic regression analysis also revealed that DM (OR: 3.325; 95% CI: 2.162-5.114; P = .000) was another independent risk factor for AKI after isolated CABG. <br /><strong>Conclusion:</strong> Low preoperative serum albumin levels result in severe acute kidney injury and increase the rate of renal replacement therapy and mortality after isolated CABG.

scholarly journals Presepsin values and prognostic nutritional index predict mortality in intensive care unit patients with sepsis: a pilot study

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Yuichiro Shimoyama ◽  
Osamu Umegaki ◽  
Noriko Kadono ◽  
Toshiaki Minami
Keyword(s):  
Multivariate Analysis ◽  
Roc Curve ◽  
Operating Characteristic ◽  
Prognostic Nutritional Index ◽  
Early Mortality ◽  
Curve Analysis ◽  
Rank Test ◽  
Roc Curve Analysis ◽  
Log Rank Test ◽  
Nutritional Index

Abstract Objective Sepsis is a major cause of mortality for critically ill patients. This study aimed to determine whether presepsin values can predict mortality in patients with sepsis. Results Receiver operating characteristic (ROC) curve analysis, Log-rank test, and multivariate analysis identified presepsin values and Prognostic Nutritional Index as predictors of mortality in sepsis patients. Presepsin value on Day 1 was a predictor of early mortality, i.e., death within 7 days of ICU admission; ROC curve analysis revealed an AUC of 0.84, sensitivity of 89%, and specificity of 77%; and multivariate analysis showed an OR of 1.0007, with a 95%CI of 1.0001–1.0013 (p = 0.0320).

Complete blood cell count risk score as a predictor of in-hospital mortality and morbidity among patients undergoing cardiac surgery with cardiopulmonary bypass

2015 ◽  
Vol 187 ◽  
pp. 60-62 ◽  
Author(s):  
Ana Paula Porto Rödel ◽  
Manuela Borges Sangoi ◽  
Larissa Garcia de Paiva ◽  
Jossana Parcianello ◽  
José Edson Paz da Silva ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Blood Cell ◽  
Hospital Mortality ◽  
Cell Count ◽  
Risk Score ◽  
Complete Blood Cell Count ◽  
Blood Cell Count ◽  
Mortality And Morbidity

scholarly journals Prognostic Nutritional Index as an independent prognostic factor in locoregionally advanced squamous cell head and neck cancer

ESMO Open ◽  
2018 ◽  
Vol 3 (6) ◽  
pp. e000425 ◽  
Author(s):  
Gema Bruixola ◽  
Javier Caballero ◽  
Federica Papaccio ◽  
Angelica Petrillo ◽  
Aina Iranzo ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Prognostic Factor ◽  
Head And Neck ◽  
Squamous Cell ◽  
Validation Cohort ◽  
Prognostic Nutritional Index ◽  
Training Cohort ◽  
Lymphocyte Ratio ◽  
Nutritional Index

BackgroundLocally advanced head and neck squamous cell carcinoma (LAHNSCC) is a heterogeneous disease in which better predictive and prognostic factors are needed. Apart from TNM stage, both systemic inflammation and poor nutritional status have a negative impact on survival.MethodsWe retrospectively analysed two independent cohorts of a total of 145 patients with LAHNSCC treated with induction chemotherapy followed by concurrent chemoradiotherapy at two different academic institutions. Full clinical data, including the Prognostic Nutritional Index (PNI), neutrophil to lymphocyte ratio and derived neutrophil to lymphocyte ratio, were analysed in a training cohort of 50 patients. Receiver operating characteristic curve analysis was used to establish optimal cut-off. Univariate and multivariate analyses of prognostic factors for overall survival (OS) were performed. Independent predictors of OS identified in multivariate analysis were confirmed in a validation cohort of 95 patients.ResultsIn the univariate analysis, low PNI (PNI<45) (p=0.001), large primary tumour (T4) (p=0.044) and advanced lymph node disease (N2b-N3) (p=0.025) were significantly associated with poorer OS in the validation cohort. The independent prognostic factors in the multivariate analysis for OS identified in the training cohort were dRNL (p=0.030) and PNI (p=0.042). In the validation cohort, only the PNI remained as independent prognostic factor (p=0.007).ConclusionsPNI is a readily available, independent prognostic biomarker for OS in LAHNSCC. Adding PNI to tumour staging could improve individual risk stratification of patients with LAHNSCC in future clinical trials.

scholarly journals Baseline prognostic nutritional index and changes in pretreatment body mass index associate with immunotherapy response in patients with advanced cancer

2020 ◽  
Vol 8 (2) ◽  
pp. e001674
Author(s):  
Paul Johannet ◽  
Amelia Sawyers ◽  
Yingzhi Qian ◽  
Samuel Kozloff ◽  
Nicholas Gulati ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Nutritional Status ◽  
Body Mass ◽  
Advanced Cancer ◽  
Objective Response ◽  
Prognostic Nutritional Index ◽  
Baseline Body Mass Index ◽  
New York University ◽  
Nutritional Index ◽  
Baseline Bmi

BackgroundRecent research suggests that baseline body mass index (BMI) is associated with response to immunotherapy. In this study, we test the hypothesis that worsening nutritional status prior to the start of immunotherapy, rather than baseline BMI, negatively impacts immunotherapy response.MethodsWe studied 629 patients with advanced cancer who received immune checkpoint blockade at New York University. Patients had melanoma (n=268), lung cancer (n=128) or other primary malignancies (n=233). We tested the association between BMI changes prior to the start of treatment, baseline prognostic nutritional index (PNI), baseline BMI category and multiple clinical end points including best overall response (BOR), objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS) and overall survival (OS).ResultsDecreasing pretreatment BMI and low PNI were associated with worse BOR (p=0.04 and p=0.0004), ORR (p=0.01 and p=0.0005), DCR (p=0.01 and p<0.0001), PFS (p=0.02 and p=0.01) and OS (p<0.001 and p<0.001). Baseline BMI category was not significantly associated with any treatment outcomes.ConclusionStandard of care measures of worsening nutritional status more accurately associate with immunotherapy outcomes than static measurements of BMI. Future studies should focus on determining whether optimizing pretreatment nutritional status, a modifiable variable, leads to improvement in immunotherapy response.

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