The Preoperative Prognostic Nutritional Index Predicts the Development of Deep Venous Thrombosis After Pancreatic Surgery

Iguchi, Tomohiro; Sugimachi, Keizō; Mano, Yohei; Kono, M; Kagawa, Masaki; Nakanoko, Tomonori; Uehara, Hideo; Shimada, Masahiko; M, Ota; Inamori, Masahiko; Morita, Masaru; Toh, Yasushi

doi:10.21873/anticanres.14195

Cited by 10 publications

(8 citation statements)

References 25 publications

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“…In a study about PNI prognosis in patients with high-grade serous ovarian cancer (HGSC), Zheng et al found that a low preoperative PNI (< 45.45) was associated with an advanced FIGO stage, increased CA125 level, more extensive ascites, residual disease and platinum resistance 28 . In general, the cutoff value of PNI fluctuated between 45 to 57 according to the already published researches [29][30][31][32][33] . Refining the cutoff value for different cancer type and individual patients is an area of active research.…”

Section: Discussionmentioning

confidence: 99%

The role of prognostic nutritional index for clinical outcomes of gastric cancer after total gastrectomy

Zhao

Feiyan

Liang

et al. 2020

Sci Rep

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The purpose of this article is to evaluate the relationship between the nutrition-based microenvironment and clinicopathological information for gastric cancer patients and to investigate the prognostic value of nutrition index for gastric cancer patients undergoing total gastrectomy. We retrospectively collected clinical information of 245 gastric cancer patients who underwent total gastrectomy in our hospital between January 1st 2005 and December 30th 2015. According to the prognostic nutritional index (PNI) level, they were divided into low PNI (< 43) group and high PNI (≥ 43) group. The relationship between PNI and the disease-free survival (DFS) and overall survival (OS) were analyzed by statistical analysis. Univariate analyses demonstrated that TNM stage (p = 0.025), patients age (p = 0.042), lymph node metastasis (p = 0.028), tumor differentiation (p = 0.037) and a low PNI (p = 0.033) were closely correlated with a poor prognosis. In multivariate analysis, TNM stage (p = 0.027) and a low PNI (p = 0.041) were found to be independently associated with poor survival. Additionally, when age was considered as a stratified factor, univariate analyses demonstrated that low PNI correlated with shorter DFS in non-elderly (< 65) patients (p = 0.022) and shorter DFS (p = 0.036) and OS (p = 0.047) in elderly (≥ 65) patients. The low prognostic nutritional index is an independent risk factor associated with poor gastric cancer survival which represents the nutritional microenvironment. Patients with low pre-operative prognostic nutritional index levels should be observed more closely after surgery to prevent the occurrence of post-operative complications in the near future.

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Section: Discussionmentioning

confidence: 99%

The role of prognostic nutritional index for clinical outcomes of gastric cancer after total gastrectomy

Zhao

Feiyan

Liang

et al. 2020

Sci Rep

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“…Additionally, it is well recognised that hypercoagulable state, stasis and endothelial injury contribute to the development of thrombosis. Patients with vascular endothelial injury caused by malnutrition may develop venous thrombosis through the aggregation of platelets or the release of cytokines from subendothelial tissue (Iguchi et al 2020 ). Clinical evidence has shown that both hypoalbuminemia (Duman et al 2019 ; Acharya et al 2020 ) and lymphocytopenia (Kuplay et al 2020 ; Yeung et al 2021 ) are related to a high incidence of thrombus.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical evidence has shown that both hypoalbuminemia (Duman et al 2019 ; Acharya et al 2020 ) and lymphocytopenia (Kuplay et al 2020 ; Yeung et al 2021 ) are related to a high incidence of thrombus. Iguchi et al found that preoperative PNI was a significant risk factor for the development of deep vein thrombosis after pancreatic surgery (Iguchi et al 2020 ). In this study, we observed that thrombus accounted for 77.4% (123/159) of adverse perioperative outcomes.…”

Section: Discussionmentioning

confidence: 99%

The need for nutritional assessment and interventions based on the prognostic nutritional index for patients with femoral fractures: a retrospective study

Fan

Zhu

et al. 2021

Perioper Med

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Background The incidence of adverse perioperative outcomes in surgery for femoral fractures is high and associated with malnutrition. Here, we identified independent factors and assessed the predictive value of the prognostic nutritional index (PNI) for perioperative adverse outcomes in patients with femoral fractures. Methods This retrospective study included 343 patients who underwent surgery for a single femur fracture. Demographic characteristics, surgery and anaesthesia records and blood test results at admission, 1 day postoperatively and before discharge were evaluated using logistic regression analysis. The discriminatory ability of the independent factors was assessed using the receiver operating characteristic curve analysis, and DeLong’s test was used to compare the area under the curve (AUC). Results Overall, 159 patients (46.4%) experienced adverse perioperative outcomes. Amongst these, 123 (35.9%) had lower limb vein thrombus, 68 (19.8%) had hospital-acquired pneumonia, 6 (1.7%) were transferred to the postoperative intensive care unit, 4 (1.2%) had pulmonary embolism, 3 (0.9%) died during hospitalisation and 9 (2.6%) had other adverse outcomes, including incision disunion, renal and liver function impairment, acute heart failure, acute cerebral infarction and stress gastroenteritis. The PNI at admission, age, postoperative hospital stay, time to admission, hypertension, combined injures and surgery type were independent factors for adverse perioperative outcomes. Based on the AUC (PNI at admission: 0.772 [0.723–0.821], P < 0.001; age: 0.678 [0.622–0.734], P < 0.001; postoperative hospital stay: 0.608 [0.548–0.668], P = 0.001; time to admission: 0.585 [0.525–0.646], P = 0.006), the PNI at admission had optimal discrimination ability, indicating its superiority over other independent factors (age vs. PNI at admission, P = 0.002; postoperative hospital stay vs. PNI at admission, P < 0.001; time to admission vs. PNI at admission, P < 0.001). Conclusions Patients with femoral fractures require a nutritional assessment and appropriate nutritional intervention at admission, and that the PNI value at admission may be a good nutritional assessment indicator.

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“…Previous studies showed that high-fat diet maintains high endogenous thrombin potential, which is associated with venous and arterial thrombosis independently of obesity and insulin resistance [31]. However, the correlation of nutritional status and VTE risk could be complex, since recent studies showed that the poor nutrition status was also associated with a high risk of developing DVT, particularly for those who underwent major surgeries [32,33]. Further studies are needed to elucidate the mechanisms underlying the association between MetS and DVT.…”

Section: Discussionmentioning

confidence: 99%

Association between metabolic syndrome and venous thromboembolism after total joint arthroplasty: a meta-analysis of cohort studies

Yang¹,

Li²,

Liang³

et al. 2020

J Orthop Surg Res

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Objective Metabolic syndrome (MetS) has been associated with hypercoagulative status. However, previous studies evaluating the association between MetS and incidence of venous thromboembolism (VTE) after total joint arthroplasty (TJA) showed inconsistent results. We performed a meta-analysis to evaluate the influence of MetS on the risk of VTE following TJA. Methods Cohort studies were identified by the search of PubMed, Embase, and the Cochrane’s Library databases. A random-effect model was used if considerable heterogeneity was detected; otherwise, a fixed-effect model was used. Subgroup analyses according to the category of VTE, definition of MetS, category of procedure, and follow-up durations were performed. Results Seven cohort studies with 1,341,457 patients that underwent TJA were included, with 118,060 MetS patients (8.8%) at baseline. With a follow-up duration up to 3 months after surgery, 9788 patients had VTE. Pooled results with a random-effect model showed that MetS was not associated with increased overall VTE after TJA (adjusted risk ratio [RR] = 1.24, 95% confidence interval [CI] 0.89 ~ 1.72, p = 0.20; I2 = 69%). The results were not significantly affected by the diagnostic criteria of MetS, category of the procedure, and follow-up durations. Subgroup analyses showed that MetS was not associated with an increased the risk of pulmonary embolism ([PE], RR 1.06, 95% CI 0.37 ~ 3.02, p = 0.91), but an increased risk of deep vein thrombosis (DVT) after TJA (RR 3.38, 95% CI 1.83 ~ 6.24, p < 0.001). Conclusions Current evidence from observational studies suggests MetS might be associated with an increased risk of DVT but not PE after TJA.

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The Preoperative Prognostic Nutritional Index Predicts the Development of Deep Venous Thrombosis After Pancreatic Surgery

Cited by 10 publications

References 25 publications

The role of prognostic nutritional index for clinical outcomes of gastric cancer after total gastrectomy

The role of prognostic nutritional index for clinical outcomes of gastric cancer after total gastrectomy

The need for nutritional assessment and interventions based on the prognostic nutritional index for patients with femoral fractures: a retrospective study

Association between metabolic syndrome and venous thromboembolism after total joint arthroplasty: a meta-analysis of cohort studies

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