Association of malnutrition status with 30-day mortality in patients with sepsis using objective nutritional indices: a multicenter retrospective study

Baek, Moon Seong; Kwon, Young Suk; Kang, Sang Soo; Shim, Daechul; Yoon, Youngsang; Kim, Jong Ho

doi:10.4266/acc.2023.01613

Cited by 2 publications

(1 citation statement)

References 43 publications

(49 reference statements)

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“…Accordingly, we dichotomized the creatinine level to the upper limit of the normal range by sex to be adaptable to other institutions. Malnutrition is associated with 30-day mortality in patients with sepsis [32]. Therefore, PNI was chosen due to its simplicity and objectivity, which were necessary for the audit.…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of a Predictive Model for In-Hospital Mortality from Perioperative Bacteremia in Gastrointestinal Surgery

Taki,

Sato,

Watanabe

et al. 2024

Preprint

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Purpose Prognostic scores require fluctuating values, such as respiratory rate, which are unsuitable for retrospective auditing. Therefore, this study aimed to develop and validate a predictive model for in-hospital mortality associated with gastrointestinal surgery for retrospective auditing. Methods Data from patients with bacteremia related to gastrointestinal surgery performed at Shizuoka General Hospital between July 2006 and December 2021 were extracted from a prospectively maintained database. Patients suspected of having a positive blood culture with contaminating bacteria or missing laboratory data were excluded. Remaining patients were divided into deviation (July 2006–November 2016) and validation cohorts (December 2016–December 2021) at a 2:1 ratio. A logistic regression model estimated the odds ratios (ORs) and created a predictive model for in-hospital mortality. The model was evaluated using receiver operating characteristic (ROC) curves and calibration plots. Results Of 20,637 gastrointestinal surgeries, 398 resulted in bacteremia. The median age of patients with bacteremia was 72 years, and 66.1% were male. The most common pathogens were Staphylococcus (13.9%), followed by Bacteroides (12.4%) and Escherichia (11.4%). Multivariable logistic regression showed that creatinine abnormality (P < 0.001, OR = 3.23), decreased prognostic nutritional index (P < 0.001, OR = 0.91/unit), and age ≥ 75 years (P = 0.016, OR = 2.16) were independent prognostic factors for in-hospital mortality. The area under the ROC curve of the predictive model was 0.775 in the validation cohort. The calibration plot revealed that the model overestimated mortality in the validation cohort. Conclusions Using age, creatinine level, albumin level, and lymphocyte count, the model accurately predicted in-hospital mortality after bacteremia infection related to gastrointestinal surgery, demonstrating its suitability for retrospective audits.

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Section: Discussionmentioning

confidence: 99%

Development and Validation of a Predictive Model for In-Hospital Mortality from Perioperative Bacteremia in Gastrointestinal Surgery

Taki,

Sato,

Watanabe

et al. 2024

Preprint

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Nonlinear correlation between prognostic nutritional indices (PNI) and patients with sepsis: a retrospective study based on the MIMIC database.

Han,

Qi,

Yuan

et al. 2024

Preprint

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Background: The objective of this study was to explore the association between PNI and mortality among sepsis patients. Methods: Data in the present study were obtained from MIMIC-IV. PNI was calculated as follows: serum albumin concentration (g/L) + 0.005 × lymphocyte count. The primary outcome of this study was in-hospital mortality. COX proportional hazard regression analysis was conducted to examine the association between PNI and in-hospital mortality. A linear trend was evaluated by including the median PNI of each group as a continuous variable in the model. Restricted cubic spline (RCS) analysis was employed to explore the linear relationship between PNI and the risk of in-hospital mortality and to investigate the interaction between PNI and different factors. Results: A total of 2794 patients were included in this study and divided into four groups (Q1-Q4) according to PNI quartile values. In the fully adjusted model, in-hospital mortality of patients in the highest quartile group of PNI values was 49.4% (HR = 0.506, 95% CI: 0.342-0.747, P = 0.001) lower than those in the lowest quartile group, respectively, with a statistically significant trend toward increased risk, Ptrend < 0.001. RCS analysis showed that an L-shaped association between PNI and in-hospital mortality. Subgroup analyses showed a association between PNI and in-hospital mortality in different strata of patients, with a negative correlation between PNI and in-hospital mortality in all groups (HR <1 in each group). Conclusions: There is a strong correlation between low PNI and an increased risk of death during hospitalization in patients with sepsis. An L-shaped association was observed between PNI and in-hospital mortality in patients with sepsis, with an inflection point at 33.99.

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Association of malnutrition status with 30-day mortality in patients with sepsis using objective nutritional indices: a multicenter retrospective study

Cited by 2 publications

References 43 publications

Development and Validation of a Predictive Model for In-Hospital Mortality from Perioperative Bacteremia in Gastrointestinal Surgery

Development and Validation of a Predictive Model for In-Hospital Mortality from Perioperative Bacteremia in Gastrointestinal Surgery

Nonlinear correlation between prognostic nutritional indices (PNI) and patients with sepsis: a retrospective study based on the MIMIC database.

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