Prognostic nutritional index (PNI) is an independent predictor for functional outcome after hip fracture in the elderly: a prospective cohort study

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Archives of Osteoporosis Pub Date : 2024-11-05 DOI:10.1007/s11657-024-01469-1

Yimin Chen, Mingjian Bei, Gang Liu, Jing Zhang, Yufeng Ge, Zhelun Tan, Weidong Peng, Feng Gao, Chao Tu, Maoyi Tian, Minghui Yang, Xinbao Wu

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引用次数: 0

Abstract

Summary

The prognostic nutritional index (PNI) is a useful tool for assessing nutritional status using serum albumin and lymphocyte count. This study indicates that a higher preoperative PNI correlates with improved mobility and health-related quality of life during the initial postoperative period in elderly patients with hip fractures.

Purpose

To investigate the prognostic value of the prognostic nutritional index (PNI) in predicting mobility and health-related quality of life (HRQoL) in elderly hip fracture patients after surgery.

Methods

We prospectively involved patients aged 65 and above, who could walk freely before injury and underwent surgery between 2018 and 2019. Admission PNI was calculated as serum albumin (g/L) + 5 × total lymphocyte count (× 10⁹/L). Patients were classified into two groups based on PNI median value. All patients were followed up by telephone for four times (30-day, 120-day, 1-year, and 3-year after surgery). The Fracture Mobility Score (FMS) and EuroQol 5-Dimension 5-Level (EQ-5D 5L) were used to evaluate mobility and HRQoL, respectively.

Results

Of 705 eligible patients, 487 completed all assessments. Patients in the higher PNI group had a significantly increased possibility of achieving unrestricted mobility at the 120-day follow-up (OR 1.69, 95% CI 1.10–2.61, P.adj = 0.017), while no significant differences were observed at other follow-ups. Additionally, patients in the higher PNI group had a significantly higher EQ-5D utility value at the 30-day follow-up (P.adj = 0.015). A linear regression model with adjusting for all confounders showed that admission PNI value was positively associated with EQ-5D utility values at 30-day, 120-day, and 1-year follow-up assessments (P.adj = 0.011, P.adj = 0.001, and P.adj = 0.030, respectively). However, this correlation was not observed at the 3-year time point (P.adj = 0.079).

Conclusion

The PNI is a valuable predictor of functional outcomes in elderly patients with hip fractures following surgery.

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预后营养指数（PNI）是老年人髋部骨折后功能预后的独立预测指标：一项前瞻性队列研究

摘要预后营养指数（PNI）是一种利用血清白蛋白和淋巴细胞计数评估营养状况的有用工具。这项研究表明，术前较高的 PNI 与老年髋部骨折患者术后初期活动能力和健康相关生活质量的改善相关。目的研究预后营养指数（PNI）在预测老年髋部骨折患者术后活动能力和健康相关生活质量（HRQoL）方面的预后价值。方法我们对年龄在 65 岁及以上、伤前可自由行走且在 2018 年至 2019 年期间接受手术的患者进行了前瞻性研究。入院 PNI 的计算方法为血清白蛋白（g/L）+ 5 × 总淋巴细胞计数（×109/L）。根据 PNI 中位值将患者分为两组。所有患者均接受了四次电话随访（术后 30 天、120 天、1 年和 3 年）。骨折活动度评分（FMS）和EQ-5D 5级（EQ-5D 5L）分别用于评估活动度和HRQoL。在 120 天的随访中，PNI 较高组患者实现无限制活动的可能性显著增加（OR 1.69，95% CI 1.10-2.61，P.adj = 0.017），而在其他随访中未观察到显著差异。此外，在 30 天的随访中，PNI 较高组患者的 EQ-5D 实用价值明显更高（P.adj = 0.015）。调整所有混杂因素的线性回归模型显示，入院时的 PNI 值与 30 天、120 天和 1 年随访评估时的 EQ-5D 实用价值呈正相关（P.adj = 0.011、P.adj = 0.001 和 P.adj = 0.030）。结论 PNI 是预测老年髋部骨折患者术后功能预后的重要指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Osteoporosis ENDOCRINOLOGY & METABOLISMORTHOPEDICS -ORTHOPEDICS

CiteScore

5.50

自引率

10.00%

发文量

133

期刊介绍： Archives of Osteoporosis is an international multidisciplinary journal which is a joint initiative of the International Osteoporosis Foundation and the National Osteoporosis Foundation of the USA. The journal will highlight the specificities of different regions around the world concerning epidemiology, reference values for bone density and bone metabolism, as well as clinical aspects of osteoporosis and other bone diseases.