Prognostic Nutritional Index (PNI): a Potential Biomarker For Preoperative Evaluation of Patients Undergoing Abdominal Surgery

Abstract

The prognostic nutritional index (PNI¹) has been widely used for the prediction of surgical risk in patients with gastrointestinal malignancy. The aim of this study was to evaluate PNI values to predict the outcome in various categories of abdominal surgery with the objective of identifying the patients at risk in order to avoid morbidity and mortality. One hundred patients undergoing surgical interventions for abdominal conditions both in emergency and elective settings in the age group of 10–80 years of either sex were included in this prospective study. The PNI of each patient was calculated as 10 × albumin (g/dl) + 0·005 × total lymphocyte count (per mm³). The patients were grouped into low PNI (PNI < 45) and high PNI (PNI > 45) groups. The chi-square test or Fisher exact test was applied for statistical analysis and a p-value of < 0.05 was considered significant. The PNI level was found to be low in female patients (p-value 0.017). There was a high incidence of co-morbidities amongst patients with low PNI (p-value 0.001). More patients in the PNI < 45 group needed ICU care (p-value 0.021). The length of hospital stays (p-value 0.001) and the mortality rate were found to be high (p-value 0.016) in the PNI < 45 group. The PNI has been found to be a simple and useful biomarker which can define the baseline risk and predict postoperative complications and long-term outcomes in abdominal surgery.