Clinical significance of the prognostic nutritional index in patients undergoing cardiovascular surgery

Hayashi, Jun; Uchida, Tetsuro; Sho, Ri; Hamasaki, Azumi; Kuroda, Yasuhiro; Yamashita, Atsushi; Sadahiro, Mitsuaki

doi:10.1007/s11748-020-01300-x

Cited by 24 publications

(22 citation statements)

References 19 publications

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“…In addition, the mean length of stay on mechanical ventilation and length of stay in the intensive care unit were found to be significantly higher in this group [Lee 2020]. In another study by Hayashi et al, low PNI was shown as an independent predictor of mortality after cardiac operations (hazard ratio 0.40; 95% confidence interval 0.18-0.90, P = .026) [Hayashi 2020].…”

Section: E654mentioning

confidence: 67%

The Importance of Prognostic Nutritional Index in Predicting Acute Renal Failure After On-Pump Coronary Artery Bypass Operations in Patients with Insulin-Dependent Diabetes Mellitus

Gücü

Ozluk

Guvenc

et al. 2021

HSF

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Background: After coronary artery bypass graft (CABG) operations, acute kidney injury (AKI) appears at 5-30% rates, and this rate increases even more in patients with diabetes mellitus (DM). Prognostic nutritional index (PNI) is known as a valuable parameter that affects cardiovascular surgery outcomes. In this current study, we aimed to investigate the importance of PNI value in predicting AKI after on-pump CABG operations in insulin-dependent diabetic patients. Methods: A total of 254 consecutive patients with insulin-dependent diabetes who underwent on-pump CABG in our clinic between January 2016 and January 2020 retrospectively were included in this study. In the postoperative period, patients were registered as the renal failure group (Group 1), and those who did not develop renal failure were registered as Group 2. Results: A total of 255 patients with DM were included in the study. There were 82 patients in Group 1 and 173 patients in Group 2. There was no difference between the groups, in terms of age, gender, smoking, and hyperlipidemia rates. Hypertension rate significantly was higher in Group 2 (P = .001). In multivariate logistic regression analysis, hypertension (OR: 1.226, 95% CI: 1.114-2.459, P = .026), need for inotropic support (OR: 1.128, 95% CI: 1.070-1.784, P = .033), increased blood product use (OR: 1.291, 95% CI: 1.112-2.156, P = .021) preoperative high creatinine (OR: 3.563, 95% CI: 2.497-5.559, P < .001), and PNI (OR: 1.327, 95% CI: 1.118-2.785, P = .012) were independent predictors of AKI. Conclusion: In our study, we determined PNI value as an independent predictor in predicting acute renal injury occurring after on-pump CABG operations in patients with insulin-dependent DM.

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Section: E654mentioning

confidence: 67%

The Importance of Prognostic Nutritional Index in Predicting Acute Renal Failure After On-Pump Coronary Artery Bypass Operations in Patients with Insulin-Dependent Diabetes Mellitus

Gücü

Ozluk

Guvenc

et al. 2021

HSF

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“…Keskin et al [24] reported a significant correlation between PNI score and both in-hospital and long-term mortality in patients undergoing CABG. Hayashi et al [25] found that higher PNI scores were correlated with lower mechanical ventilation duration, ICU stay, and infection rate. The authors reported lower PNI scores to be among independent predictors for mortality in their multivariate analysis.…”

Section: Discussionmentioning

confidence: 99%

Prognostic nutritional index as a marker of mortality: an observational cohort study of patients undergoing cardiac surgery

Gücü¹,

Ozluk²,

Sunbul³

et al. 2021

Reviews in Cardiovascular Medicine

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Nutritional problem of the patient is a valuable stiuation in patients undergoing surgery. In this study, we aimed to investigate the relationship between prognostic nutritional index (PNI) and postoperative in-mortality in patients undergoing cardiac surgery. 1003 patients undergoing on-pump cardiac surgery in our hospital between January 2016-January 2020 were included in this study retrospectively. Patients were divided into two groups based on in-hospital mortality, as survivors (Group I, n = 934) and non-survivors (Group II, n = 69). Their preoperative nutritional status was determined using the PNI. Compared to survivors, non-survivors were found to have a significantly higher mean age (62.5 ± 10.8 vs. 67.45 ± 10.1, P < 0.001) and significantly lower mean preoperative ejection fraction (51.6 ± 0.3 vs. 44.5 ± 1.2, P < 0.001). And combined cardiac surgery rate was significantly higher in non-survivors (P = 0.009). Also nonsurvivors had a significantly lower mean PNI compared to survivors (44.76 ± 7.63 vs. 48.34 ± 6.71, P < 0.001). Multivariate analysis Model 1 revealed that age (Odds ratio (OR): 1.

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“…A study enrolled patients undergoing cardiovascular surgery and found that a low PNI score was substantially linked with postoperative complications and survival and PNI score might be a valuable and reliable tool for assessing nutritional status before surgery, and it should be taken into account when determining the indication for and strategy for cardiovascular surgery (24). One study studied the association between PNI score and stable coronary artery disease and discovered that the PNI score was independently associated with higher MCE rates (25).…”

Section: Discussionmentioning

confidence: 99%

The change in nutritional status is related to cardiovascular events in patients with pacemaker implantation: A 4-year follow-up study

et al. 2022

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BackgroundThe aim of our study was to evaluate changes in nutritional status as measured by the prognostic nutritional index (PNI) and geriatric nutritional risk index (GNRI) scores, and their abilities to predict clinical prognosis in patients with pacemaker implantation (PMI).MethodsA total of 595 patients who underwent permanent PMI from January 2011 to December 2020 were included. PNI and GNRI scores were separately calculated at the beginning day of PMI operation and at the end of 12-month follow-up, and their net changes (Δ) were calculated by PNI or GNRI scores at follow-up minus the corresponding scores on admission. The cohort patients were divided into low risk of malnutritional status (ΔPNI or ΔGNRI scores ≥ 0) and high risk of malnutritional status (ΔPNI or ΔGNRI scores < 0) groups. Primary outcome measure was a composite major adverse cardiovascular event (MCE), defined as heart failure hospitalization (HFH), myocardial infarction (MI), stroke, or death from any cause, presented as hazard ratios (HR) with 95% confidence intervals (CI) calculated by MCE in the crude or multivariate-adjusted Cox Proportional Hazards models. Receiver operating characteristic (ROC) curve analysis was used to compare the differential ability to predict incident MCEs betweenΔPNI andΔGNRI scores.ResultsIn total, 16% of patients developed the MCE during the follow-up. The cumulative event rates determined by Kaplan–Meier analysis were significantly higher in the high risk of malnutritional patients compared to the low risk of malnutritional patients (P < 0.05). Adjusted multivariate analysis showed that decreased PNI scores (HR: 2.228, 95% CI: 1.482–3.350) and decreased GNRI scores (HR: 2.178, 95% CI: 1.439–3.295) were independently associated with favorable outcomes. ROC curve analysis revealed an area under curve (AUC) of 0.586 forΔPNI scores and AUC of 0.592 for ΔGNRI scores, but their predictive abilities were not statistically different.ConclusionEither positive change of PNI or GNRI scores were associated with reduced risk of MCEs in patients with PMI, and they have similar ability to predict clinical cardiometabolic risk. Additional enhancing nutritional status during follow-up may help to prevent unfavorable prognosis in clinical practices.

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Clinical significance of the prognostic nutritional index in patients undergoing cardiovascular surgery

Cited by 24 publications

References 19 publications

The Importance of Prognostic Nutritional Index in Predicting Acute Renal Failure After On-Pump Coronary Artery Bypass Operations in Patients with Insulin-Dependent Diabetes Mellitus

The Importance of Prognostic Nutritional Index in Predicting Acute Renal Failure After On-Pump Coronary Artery Bypass Operations in Patients with Insulin-Dependent Diabetes Mellitus

Prognostic nutritional index as a marker of mortality: an observational cohort study of patients undergoing cardiac surgery

The change in nutritional status is related to cardiovascular events in patients with pacemaker implantation: A 4-year follow-up study

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