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Yilmaz S, Kurt M, Dülgeroğlu TC. Investigation of the predictive value of systemic immune inflammation index (SII) and prognostic nutritional index (PNI) on mortality in patients with endoprosthesis after hip fracture. Medicine (Baltimore) 2024; 103:e38063. [PMID: 38701306 PMCID: PMC11062679 DOI: 10.1097/md.0000000000038063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 04/08/2024] [Indexed: 05/05/2024] Open
Abstract
In this research, we aimed to investigate the predictive value of the systemic immune inflammation index and prognostic nutritional index on mortality among patients with an endoprosthesis after a hip fracture. In this retrospective, cross-sectional study, a total of 915 patient files applied to our hospital between 2020 and 2023 with an endoprosthesis after a hip fracture were subjected to the study. The patients were divided into 2 groups: alive (n = 396; 43.3%) and deceased (n = 519; 56.7%). The eosinophil-to-lymphocyte ratio, hemoglobin-to-red cell distribution width ratio (HRR), mean platelet volume-to-platelet ratio (MPVPR), neutrophil-to-lymphocyte ratio, monocyte/lymphocyte ratio, platelet-to-lymphocyte ratio, MPV-to-lymphocyte ratio, monocyte-to-eosinophil ratio (MER), neutrophile-to-monocyte ratio, systemic inflammation index (SII), and prognostic nutritional index (PNI) parameters of the patients were evaluated. The mortality rate was higher among male patients, with a statistically significant difference (P < .05). The follow-up duration, albumin, HGB, eosinophil, lymphocyte, eosinophil %, eosinophil-to-lymphocyte ratio, HRR, and PNI means were significantly higher in the living group (P < .05). Age, MPV, MPVPR, neutrophil-to-lymphocyte ratio, monocyte/lymphocyte ratio, platelet-to-lymphocyte ratio, MPV-to-lymphocyte ratio, MER, and systemic inflammation index were significantly higher in the deceased group (P < .05). The predictive value of gender (B = -0.362; P < .01), age (B = 0.036; P < .01), HRR (B = -1.100; P < .01), MPVPR (B = 8.209; P < .01), MER (B = 0.006; P < .01), and PNI (B = -0.078; P < .01) were statistically significant at the multivariate level. The time of death was significantly predicted by gender (B = 0.10; P < .05), age (B = -0.02; P < 0 = 1), HRR (B = 0.61; P < .01), MPVPR (r = -4.16; P < .01), MER (B = -0.01; P < .05), and PNI (B = 0.03; P < .01). The predictive value of PNI for the 30-day mortality rate was statistically significant (AUC: 0.643; P < .01). For a PNI cutoff value of 34.475, sensitivity was 69.7%, and specificity was 51.1%. The PNI has predictive value both in estimating overall mortality and in predicting the 30-day mortality rates among patients undergoing endoprosthesis after a hip fracture.
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Affiliation(s)
- Selçuk Yilmaz
- Department of Orthopedics and Traumatology, Antalya City Hospital, Antalya, Turkey
| | - Mehmet Kurt
- Department of Orthopedics and Traumatology, Faculty of Medicine, Kutahya Health Sciences University, Kütahya, Turkey
| | - Turan Cihan Dülgeroğlu
- Department of Orthopedics and Traumatology, Faculty of Medicine, Kutahya Health Sciences University, Kütahya, Turkey
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Corrigendum to Clinical significance of prognostic nutrition index in hospitalized patients with COVID-19: Results from single-center experience with systematic review and meta-analysis. Nutr Clin Pract 2024; 39:507. [PMID: 36694936 PMCID: PMC11186030 DOI: 10.1002/ncp.10950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
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Hu JW, Shi T. Postoperative Prognostic Nutritional Index and Fibrinogen Could Well Predict Poor Prognosis of Acute Type A Aortic Dissection Patients After Surgery. Braz J Cardiovasc Surg 2024; 39:e20220185. [PMID: 38426429 PMCID: PMC10903007 DOI: 10.21470/1678-9741-2022-0185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 10/01/2022] [Indexed: 03/02/2024] Open
Abstract
INTRODUCTION Inflammatory and immunological factors play pivotal roles in the prognosis of acute type A aortic dissection. We aimed to evaluate the prognostic values of immune-inflammatory parameters in acute type A aortic dissection patients after surgery. METHODS A total of 127 acute type A aortic dissection patients were included. Perioperative clinical data were collected through the hospital's information system. The outcomes studied were delayed extubation, reintubation, and 30-day mortality. Multivariate logistic regression analysis and receiver operating characteristic analysis were used to screen the risk factors of poor prognosis. RESULTS Of all participants, 94 were male, and mean age was 51.95±11.89 years. The postoperative prognostic nutritional indexes were lower in delayed extubation patients, reintubation patients, and patients who died within 30 days. After multivariate regression analysis, the postoperative prognostic nutritional index was a protective parameter of poor prognosis. The odds ratios (95% confidence interval) of postoperative prognostic nutritional index were 0.898 (0.815, 0.989) for delayed extubation and 0.792 (0.696, 0.901) for 30-day mortality. Low postoperative fibrinogen could also well predict poor clinical outcomes. The odds ratios (95% confidence interval) of postoperative fibrinogen were 0.487 (0.291, 0.813) for delayed extubation, 0.292 (0.124, 0.687) for reintubation, and 0.249 (0.093, 0.669) for 30-day mortality. CONCLUSION Postoperative prognostic nutritional index and postoperative fibrinogen could be two promising markers to identify poor prognosis of acute type A aortic dissection patients after surgery.
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Affiliation(s)
- Jia-Wen Hu
- Department of Cardiovascular Surgery, First Affiliated Hospital of
Medical School, Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Tao Shi
- Department of Cardiovascular Surgery, First Affiliated Hospital of
Medical School, Xi’an Jiaotong University, Xi’an, People’s Republic of China
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Kang N, Gu H, Ni Y, Wei X, Zheng S. Prognostic and clinicopathological significance of the Prognostic Nutritional Index in patients with gastrointestinal stromal tumours undergoing surgery: a meta-analysis. BMJ Open 2022; 12:e064577. [PMID: 36456008 PMCID: PMC9717127 DOI: 10.1136/bmjopen-2022-064577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES Previous studies have investigated the prognostic value of the Prognostic Nutritional Index (PNI) in patients with gastrointestinal stromal tumours (GISTs). However, the results have been inconsistent. We performed a meta-analysis to quantitatively determine the prognostic and clinicopathological significance of PNI in GISTs. DESIGN This meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Pooled HRs and 95% CIs were calculated to estimate the prognostic value of PNI in patients with GISTs. Combined ORs and corresponding 95% CIs were used to evaluate the association between the PNI and clinicopathological characteristics. DATA SOURCES The electronic databases PubMed, Web of Science, Embase and Cochrane Library were thoroughly searched from inception to December 2021. ELIGIBILITY CRITERIA A random-effects model or fixed-effects model was selected based on the level of heterogeneity among the included studies. RESULTS Eight studies comprising 2307 patients were included in this meta-analysis. A low PNI was significantly associated with worse recurrence-free survival (RFS) (HR 2.02, 95% CI 1.66 to 2.47, p<0.001) and overall survival (OS) (HR 4.35, 95% CI 1.25 to 16.83, p=0.033) in patients with GISTs. In addition, a low PNI was significantly associated with tumour size ≥5 cm (OR 1.65, 95% CI 1.21 to 2.24, p=0.002) and primary tumour site in small intestine/colorectum/extra-GISTs (OR 2.03, 95% CI 1.26 to 3.26, p=0.004). CONCLUSIONS Patients with GISTs and a lower PNI had inferior RFS and OS. Patients with GISTs and a low PNI may have a higher risk of tumour recurrence.
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Affiliation(s)
- Niansong Kang
- Department of Gastroenterology, Yuyao Traditional Chinese Medicine Hospital, Ningbo, Zhejiang, China
| | - Hongping Gu
- Department of Gastroenterology, Yuyao Traditional Chinese Medicine Hospital, Ningbo, Zhejiang, China
| | - Yuehan Ni
- Department of Internal Medicine, Yuyao Traditional Chinese Medicine Hospital, Ningbo, Zhejiang, China
| | - Xia Wei
- Department of Gastroenterology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Sihui Zheng
- Department of Gastroenterology, The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
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Hung KC, Ko CC, Wang LK, Liu PH, Chen IW, Huang YT, Sun CK. Association of Prognostic Nutritional Index with Severity and Mortality of Hospitalized Patients with COVID-19: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2022; 12:diagnostics12071515. [PMID: 35885421 PMCID: PMC9322949 DOI: 10.3390/diagnostics12071515] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/17/2022] [Accepted: 06/19/2022] [Indexed: 01/08/2023] Open
Abstract
The associations of prognostic nutritional index (PNI) with disease severity and mortality in patients with coronavirus disease 2019 (COVID-19) remain unclear. Electronic databases, including MEDLINE, EMBASE, Google scholar, and Cochrane Library, were searched from inception to 10 May 2022. The associations of PNI with risk of mortality (primary outcome) and disease severity (secondary outcome) were investigated. Merged results from meta-analysis of 13 retrospective studies (4204 patients) published between 2020 and 2022 revealed a lower PNI among patients in the mortality group [mean difference (MD): −8.65, p < 0.001] or severity group (MD: −5.19, p < 0.001) compared to those in the non-mortality or non-severity groups. A per-point increase in PNI was associated with a reduced risk of mortality [odds ratio (OR) = 0.84, 95% CI: 0.79 to 0.9, p < 0.001, I2 = 67.3%, seven studies] and disease severity (OR = 0.84, 95% CI: 0.77 to 0.92, p < 0.001, I2 = 83%, five studies). The pooled diagnostic analysis of mortality yielded a sensitivity of 0.76, specificity of 0.71, and area under curve (AUC) of 0.79. Regarding the prediction of disease severity, the sensitivity, specificity, and AUC were 0.8, 0.61, and 0.65, respectively. In conclusion, this study demonstrated a negative association between PNI and prognosis of COVID-19. Further large-scale trials are warranted to support our findings.
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Affiliation(s)
- Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City 71004, Taiwan; (K.-C.H.); (L.-K.W.)
- Department of Hospital and Health Care Administration, College of Recreation and Health Management, Chia Nan University of Pharmacy and Science, Tainan City 71710, Taiwan
| | - Ching-Chung Ko
- Department of Medical Imaging, Chi Mei Medical Center, Tainan City 71004, Taiwan;
- Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan City 71710, Taiwan
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung City 80424, Taiwan
| | - Li-Kai Wang
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City 71004, Taiwan; (K.-C.H.); (L.-K.W.)
- Department of Hospital and Health Care Administration, College of Recreation and Health Management, Chia Nan University of Pharmacy and Science, Tainan City 71710, Taiwan
| | - Ping-Hsin Liu
- Department of Anesthesiology, E-Da Hospital, Kaohsiung City 82445, Taiwan;
| | - I-Wen Chen
- Department of Anesthesiology, Chi Mei Hospital, Liouying, Tainan City 710402, Taiwan
- Correspondence: (I.-W.C.); (Y.-T.H.); (C.-K.S.)
| | - Yen-Ta Huang
- Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City 70101, Taiwan
- Correspondence: (I.-W.C.); (Y.-T.H.); (C.-K.S.)
| | - Cheuk-Kwan Sun
- Department of Emergency Medicine, E-Da Hospital, Kaohsiung City 82445, Taiwan
- College of Medicine, I-Shou University, Kaohsiung City 84001, Taiwan
- Correspondence: (I.-W.C.); (Y.-T.H.); (C.-K.S.)
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Ünver Ulusoy T, Hekimoğlu CH, Kayhan S, Altın N, Şencan İ. Prognostic nutritional index: Is it associated with the prognosis of Crimean Congo hemorrhagic fever. J Med Virol 2022; 94:4910-4917. [PMID: 35726154 DOI: 10.1002/jmv.27947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/30/2022] [Accepted: 06/14/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION The prognostic nutritional index (PNI) is calculated using total serum lymphocyte counts and albumin levels. We aimed to analyze the role of PNI in predicting intensive care unit (ICU) referral and mortality in patients with Crimean Congo hemorrhagic fever (CCHF). MATERIALS AND METHODS Our target population was adult (age >18) patients who presented between March 2015 and October 2021 within 5 days of symptom emergence and were diagnosed with CCHF. The predictive value of PNI was analyzed by the receiver operating curve analysis. The patients were categorized based on the severity grading scores (SGS) as mild, moderate, and severe. The relationship between PNI and ICU referral and mortality was analyzed by logistic regression analysis. RESULTS Overall, 115 patients with the diagnosis of CCHF were included. 13.9% (n = 16) of the patients were referred to ICU while 11.3% (n = 13) died. A comparison of the patients with different SGS grades revealed that they were significantly different regarding PNI (p < 0.001). There was a significant negative correlation between PNI and SGS (r = -0.662; p < 0.001). PNI had a PV regarding ICU referral and mortality ([area under the curve [AUC] = 0.723, 95% confidence interval [CI]: 0.609-0.836, p = 0.004 [AUC = 0.738, 95% CI: 0.613-0.863, p = 0.005]). The PNI threshold was 36.1 for ICU referral and mortality. The rates of female patients, hospitalization periods longer than 1 week, platelet apheresis replacement, diabetes mellitus, bleeding history, ICU admission, and mortality were significantly higher in patients with a PNI of lower than 36.1 (p < 0.05). CONCLUSION PNI can predict ICU referral and mortality in patients admitted due to CCHF.
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Affiliation(s)
- Tülay Ünver Ulusoy
- Department of Infectious Diseases and Clinical Microbiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Can H Hekimoğlu
- General Directorate of Public Health, Infection Disease Department, Division of Healthcare-Associated Infectıons, Ankara, Turkey
| | - Sanem Kayhan
- Department of Internal Medicine, Dışkapı Yıldırım Beyazıt Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Nilgün Altın
- Department of Infectious Diseases and Clinical Microbiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - İrfan Şencan
- Department of Infectious Diseases and Clinical Microbiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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Can B, Senturk Durmus N, Olgun Yıldızeli S, Kocakaya D, Ilhan B, Tufan A. Nutrition risk assessed by Nutritional Risk Screening 2002 is associated with in-hospital mortality in older patients with COVID-19. Nutr Clin Pract 2022; 37:605-614. [PMID: 35488891 PMCID: PMC9347896 DOI: 10.1002/ncp.10860] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 03/19/2022] [Accepted: 04/02/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Although numerous studies have been performed to determine predictors of coronavirus disease 2019 (COVID-19) mortality, studies that address the geriatric age group are limited. The aim of this study was to investigate the utility of the Nutritional Risk Screening 2002 (NRS-2002) and the Geriatric 8 (G8) screening tools in predicting clinical outcomes in older adults hospitalized with COVID-19. METHODS Patients aged ≥60 years who were hospitalized with COVID-19 in the second wave of the pandemic were included in the study. COVID-19 infection was demonstrated by a positive real-time reverse transcriptase-polymerase chain reaction on nasopharyngeal swab or positive radiological findings. Disease severity was determined as defined by the National Institutes of Health. Patient demographics, laboratory values on admission, comorbidities, and medications were recorded. The NRS-2002 and the G8 screening tools were performed for all patients by the same geriatrician. Primary outcome was in-hospital mortality. RESULTS A total of 121 patients were included. Mean age was 75 ± 9 years, and 51% were female. Mean body mass index was 27 ± 4.5 kg/m2 . Sixty-nine percent of the patients had nutrition risk according to the NRS-2002. Eighty-nine percent of the patients had a G8 score ≤14. In-hospital mortality occurred in 26 (22%) patients. Older age and having nutrition risk as determined by the NRS-2002 were independently associated with a higher risk of in-hospital mortality in older patients with COVID-19. CONCLUSION The NRS-2002 tool provides rapid assessment for risk stratification in hospitalized older patients with COVID-19.
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Affiliation(s)
- Busra Can
- Department of Internal Medicine, Division of Geriatrics, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Nurdan Senturk Durmus
- Department of Internal Medicine, Division of Geriatrics, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Sehnaz Olgun Yıldızeli
- Department of Pulmonary Medicine, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Derya Kocakaya
- Department of Pulmonary Medicine, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Birkan Ilhan
- Department of Internal Medicine, Division of Geriatrics, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Asli Tufan
- Department of Internal Medicine, Division of Geriatrics, Faculty of Medicine, Marmara University, Istanbul, Turkey
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Fernandes AL, Reis BZ, Murai IH, Pereira RMR. Prognostic Nutritional Index and Oxygen Therapy Requirement Associated With Longer Hospital Length of Stay in Patients With Moderate to Severe COVID-19: Multicenter Prospective Cohort Analyses. Front Nutr 2022; 9:802562. [PMID: 35479742 PMCID: PMC9037140 DOI: 10.3389/fnut.2022.802562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 02/22/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose To evaluate whether the prognostic nutritional index (PNI) is related to the oxygen therapy requirement at hospital admission and to ascertain the prognostic effect of the PNI and the oxygen therapy requirement as predictors of hospital length of stay in patients with moderate to severe coronavirus disease 2019 (COVID-19). Methods This is a post-hoc analysis in hospitalized patients with moderate to severe COVID-19. The participants were categorized: (1) non-oxygen therapy (moderate COVID-19 not requiring oxygen therapy); (2) nasal cannula therapy (severe COVID-19 requiring nasal cannula oxygen therapy); and (3) high-flow therapy (severe COVID-19 requiring high-flow oxygen therapy). PNI was calculated for each patient according to the following equation: serum albumin [g/dL] × 10 + total lymphocyte count [per mm3] × 0.005. The participants were categorized into malnutrition (PNI <40), mild malnutrition (PNI 40-45), and non-malnutrition (PNI > 45). Results According to PNI, malnutrition was more prevalent in the high-flow therapy group (94.9%; P < 0.001) with significantly lower PNI compared to both groups even after adjusting for the center and C-reactive protein. Patients in the high-flow therapy group [9 days (95% CI 7.2, 10.7), P < 0.001] and malnutrition status [7 days (95% CI 6.6, 7.4), P = 0.016] showed a significant longer hospital length of stay compared to their counterparts. The multivariable Cox proportional hazard models showed significant associations between both oxygen therapy requirement and PNI categories and hospital discharge. Conclusion In addition to oxygen therapy requirement, low PNI was associated with longer hospital length of stay. Our findings suggest that PNI could be useful in the assessment of nutritional status related to the prognosis of patients with moderate to severe COVID-19.
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Affiliation(s)
- Alan L Fernandes
- Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, Hospital das Clinicas HCFMUSP, São Paulo, Brazil
| | - Bruna Z Reis
- Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, Hospital das Clinicas HCFMUSP, São Paulo, Brazil.,Department of Nutrition, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Igor H Murai
- Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, Hospital das Clinicas HCFMUSP, São Paulo, Brazil
| | - Rosa M R Pereira
- Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, Hospital das Clinicas HCFMUSP, São Paulo, Brazil
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