Is the prognostic nutritional index (PNI) a useful predictive marker for postoperative complications after lung surgery?

Li, Xin

doi:10.21037/jtd.2018.12.124

Cited by 6 publications

(10 citation statements)

References 19 publications

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“…In the past studies on PNI, there is no unified algorithm for the critical value of PNI. Some studies 19 , 20 , 21 choose 45 ~ 49 as the critical value based on experience, while others 22 may draw the ROC curve to obtain the corresponding maximum Youden index to figure out the cutoff value. It is obvious that our research has developed a reasonable PNI reference value range through a comprehensive study of various factors, which is more clinically meaningful.…”

Section: Discussionmentioning

confidence: 99%

Normal reference intervals of prognostic nutritional index in healthy adults: A large multi‐center observational study from Western China

Yang

Wang

et al. 2021

Clinical Laboratory Analysis

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Background It has been widely reported that the prognostic nutritional index (PNI) played a pivotal role in nutritional assessment of surgical patients and tumor prognosis. In order to improve the accuracy of evaluation in Western China, we established reference intervals (RIs) of PNI in healthy controls. Methods A retrospective cohort study on healthy ethnic Han adults (18–79 years) was conducted to explore the influences of age, gender, study centers, and instruments on PNI and to establish RIs. The data came from a healthy routine examination center database and laboratory information system (LIS) of four centers in Western China, and there were 200 persons selected randomly for verification of RIs. Results Five thousand eight hundred and thirty‐nine healthy candidates were enrolled. PNI showed a marked gender dependence, and males had significantly higher PNI than females across all ages (p < 0.01). We found that PNI is significantly different between age groups (p < 0.01), the value of PNI tended to decrease with age increasing. There is also an obvious influence of centers and instruments on PNI (p < 0.01). Conclusions We established reference intervals of PNI in healthy Han Chinese population in Western China and validated successfully. Further established RIs will lead to better standardizations of PNI for clinical applications.

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Section: Discussionmentioning

confidence: 99%

Normal reference intervals of prognostic nutritional index in healthy adults: A large multi‐center observational study from Western China

Yang

Wang

et al. 2021

Clinical Laboratory Analysis

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“…The PNI uses the combined effects of hypoalbuminemia and lymphocytopenia to assess the immunologic and nutritional aspects of surgical patients (13,17), and it is a pre-treatment nutritional risk strati cation tool (18). Accumulating evidence indicates that approximately 20-40% of the patients show an acute, prolonged, and profound decrease in serum albumin levels after surgery (17), and this is even more serious in patients with femoral fractures; lower serum albumin levels and total lymphocyte counts are important risk factors for predicting the 1-year mortality of elderly patients with intertrochanteric fractures (19). Consistently, in this study, multivariate regression analysis showed that the nutritional status at admission was negatively correlated with perioperative adverse outcomes in patients with femoral fractures.…”

Section: Discussionmentioning

confidence: 99%

“…The prognostic nutritional index (PNI), initially proposed by Buzby et al (13), is a comprehensive index for evaluating the preoperative nutritional status of surgical patients (14,15) and for predicting the risk of postoperative complications (14)(15)(16)(17). Currently, a low PNI, as a proxy of subpar perioperative nutritional status, is reported to be a signi cant predictor of poor postoperative outcomes and increased mortality in various malignancies (16,17). However, no studies on PNI have focused on perioperative adverse outcomes in patients undergoing surgery for femoral fractures.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Nutritional Index Is a Better Predictor of Perioperative Adverse Outcomes in Patients With Femoral Fractures: a Retrospective Study

He¹,

Fan²,

Zhu³

et al. 2021

Preprint

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Background: Surgery is usually the best treatment for patients with femoral fractures. However, the incidence of perioperative adverse outcomes in such cases is quite high. Nutrition has a major influence on fracture healing, and malnutrition is associated with higher complication rates, higher mortality rates, and longer hospitalisation periods. In this study, we aimed to identify independent risk factors and assess the predictive value of the prognostic nutritional index (PNI) for perioperative adverse outcomes in patients with femoral fractures. Methods: This retrospective observational study included 343 patients who underwent surgery for a single femur fracture at the Affiliated Hospital of Zunyi Medical University in 2018. Binary logistic regression analysis was applied to identify significant independent risk factors. The discriminatory ability of independent predictors was assessed using the receiver operating characteristic curve analysis, and DeLong's test was used to compare the area under the curve (AUC). Results: In total, 159 patients (46.4%) had perioperative adverse outcomes. PNI (OR: 0.819, 95% CI: 0.754–0.889, P < 0.001), age (OR: 1.042, 95% CI: 1.020–1.066, P < 0.001), time to admission (OR: 1.404, 95% CI: 1.117–1.765, P = 0.004), hypertension (OR: 1.912, 95% CI: 1.049–3.488, P = 0.034), combined injures (OR: 2.739, 95% CI: 1.338–5.607, P = 0.006), and operation types (OR: 3.696, 95% CI: 1.913–7.138, P < 0.001) were independent factors for perioperative adverse outcomes. Based on the AUC (PNI: 0.772, 95% CI: 0.723–0.821, P < 0.001; age: 0.678, 95% CI: 0.622–0.734, P < 0.001; time to admission: 0.585, 95% CI: 0.525–0.646, P = 0.006), the PNI had the optimal discrimination ability, indicating its superiority over other independent predictors (age vs. PNI, P = 0.002; time to admission vs. PNI, P < 0.001). Conclusions: This study showed that the PNI was a better and effective independent predictor of perioperative adverse outcomes in patients with femoral fractures. Our findings suggest that nutritional assessment at admission and appropriate intervention strategies are necessary for patients with femoral fractures.

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“…In the past studies on PNI, there is no uni ed algorithm for the critical value of PNI. Some studies [18][19][20] choose 45 ~ 49 as the critical value based on experience, while others [21] may draw the ROC curve to obtain the corresponding maximum Youden index to gure out the cut-off value. It is obvious that our research has developed a reasonable PNI reference value range through a comprehensive study of various factors, which is more clinically meaningful.…”

Section: Strength and Limitationmentioning

confidence: 99%

“…In the past studies on PNI, there is no uni ed algorithm for the critical value of PNI. Some studies [18][19][20]…”

Section: Strength and Limitationmentioning

confidence: 99%

Normal reference intervals of prognostic nutritional index in healthy adults: A large multi-center observational study from Western China

Yang

Wang

et al. 2021

Preprint

View full text Add to dashboard Cite

Background It has been widely reported that the prognostic nutritional index (PNI) played a pivotal role in nutritional assessment of surgical patients and tumor prognosis. In order to improve the accuracy of evaluation in western China, we established reference intervals (RIs) of PNI in healthy controls. Methods A retrospective cohort study on healthy ethnic Han adults (18–79 years) was conducted to explore the influences of age, gender, study centers, and instruments on PNI and to establish RIs. The data came from a healthy routine examination center database and laboratory information system (LIS) of four centers in western China, and there were 200 persons selected randomly for verification of RIs. Results 5,839 healthy candidates were enrolled. PNI showed a marked gender dependence, and males had significantly higher PNI than females across all ages (P < 0.01). We found that PNI is significantly different between age groups (P < 0.01), the value of PNI tended to decrease with age increasing. There is also an obvious influence of centers and instruments on PNI (P < 0.01). Conclusions We established reference intervals of PNI in healthy Han Chinese population in Western China, and validated successfully. Further established RIs will lead to better standardizations of PNI for clinical applications.

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Is the prognostic nutritional index (PNI) a useful predictive marker for postoperative complications after lung surgery?

Cited by 6 publications

References 19 publications

Normal reference intervals of prognostic nutritional index in healthy adults: A large multi‐center observational study from Western China

Normal reference intervals of prognostic nutritional index in healthy adults: A large multi‐center observational study from Western China

Prognostic Nutritional Index Is a Better Predictor of Perioperative Adverse Outcomes in Patients With Femoral Fractures: a Retrospective Study

Normal reference intervals of prognostic nutritional index in healthy adults: A large multi-center observational study from Western China

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