The role of the Prognostic Nutritional Index in predicting survival and rehospitalization after surgical aortic valve replacement.

IF 0.7 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Indian Journal of Thoracic and Cardiovascular Surgery Pub Date : 2025-05-01 Epub Date: 2025-01-14 DOI:10.1007/s12055-024-01891-7

Michele D'Alonzo, Baudo Massimo, Antonio Fiore, Jacopo Capussela, Gianluca Abrami, Thierry Folliguet, Claudio Muneretto

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引用次数: 0

Abstract

Purpose: The Prognostic Nutritional Index (PNI), calculated using serum albumin levels and blood lymphocyte count, reflects a patient's nutritional and immune status. It is commonly used as a prognostic tool following oncological surgery and in certain cardiovascular conditions. This study aims to assess whether the PNI can also serve as a prognostic indicator in patients undergoing surgical aortic valve replacement (SAVR).

Methods: A total of 471 low-risk patients with EuroSCORE II (European System for Cardiac Operative Risk Evaluation II) of ≤4%, who underwent isolated SAVR, were retrospectively analysed. Patients were divided into two groups based on their PNI values (cut-off, 46.75). Outcomes such as length of hospital stay, 30-day mortality, 1-year survival, and rehospitalization rates were compared between the groups.

Results: The Low PNI group consisted of 116 patients, while the High PNI group included 355 patients. The latter were younger, but both groups had comparable comorbidities. All patients underwent SAVR with a bioprosthesis. There was no significant difference in 30-day mortality between the groups (Low PNI, 2.6% vs. High PNI, 0.9%, p = 0.162). However, the 1-year survival rate was significantly lower in the Low PNI group (Low PNI, 5.2 ± 4.1% vs. High PNI, 1.7 ± 1.3%, p = 0.039). Additionally, the 1-year rehospitalization rate was significantly higher in the Low PNI group (Low PNI, 13.8 ± 6.3% vs. High PNI, 7.7 ± 2.7%, p = 0.040). Multivariate analysis identified PNI as a protective factor, while mechanical ventilation was associated with increased risk of death or rehospitalization at 1-year after SAVR.

Conclusions: The PNI is an inexpensive, accessible, and reliable tool that can be easily integrated into existing risk stratification scores for SAVR.

Graphical abstract:

Supplementary information: The online version contains supplementary material available at 10.1007/s12055-024-01891-7.

查看原文本刊更多论文

预后营养指数在预测主动脉瓣置换术后生存和再住院中的作用。

目的：利用血清白蛋白水平和血淋巴细胞计数计算的预后营养指数（PNI）反映了患者的营养和免疫状态。它通常被用作肿瘤手术后和某些心血管疾病的预后工具。本研究旨在评估PNI是否也可以作为手术主动脉瓣置换术（SAVR）患者的预后指标。方法：回顾性分析471例接受孤立性SAVR的EuroSCORE II（欧洲心脏手术风险评估系统II）评分≤4%的低危患者。根据PNI值将患者分为两组（截止值46.75）。比较两组患者住院时间、30天死亡率、1年生存率和再住院率等结果。结果：低PNI组116例，高PNI组355例。后者更年轻，但两组都有相似的合并症。所有患者均行生物假体SAVR。两组间30天死亡率无显著差异（低PNI， 2.6% vs高PNI， 0.9%, p = 0.162）。然而，低PNI组的1年生存率明显较低（低PNI， 5.2±4.1% vs高PNI， 1.7±1.3%,p = 0.039）。此外，低PNI组1年再住院率显著高于低PNI组（低PNI为13.8±6.3%，高PNI为7.7±2.7%,p = 0.040）。多因素分析确定PNI是一个保护因素，而机械通气与SAVR后1年死亡或再住院风险增加相关。结论：PNI是一种廉价、可获得和可靠的工具，可以很容易地整合到现有的SAVR风险分层评分中。图片摘要：补充资料：在线版本包含补充资料，网址为10.1007/s12055-024-01891-7。

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来源期刊

Indian Journal of Thoracic and Cardiovascular Surgery CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

1.20

自引率

14.30%

发文量

141

期刊介绍： The primary aim of the Indian Journal of Thoracic and Cardiovascular Surgery is education. The journal aims to dissipate current clinical practices and developments in the area of cardiovascular and thoracic surgery. This includes information on cardiovascular epidemiology, aetiopathogenesis, clinical manifestation etc. The journal accepts manuscripts from cardiovascular anaesthesia, cardiothoracic and vascular nursing and technology development and new/innovative products.The journal is the official publication of the Indian Association of Cardiovascular and Thoracic Surgeons which has a membership of over 1000 at present.DescriptionThe journal is the official organ of the Indian Association of Cardiovascular-Thoracic Surgeons. It was started in 1982 by Dr. Solomon Victor and ws being published twice a year up to 1996. From 2000 the editorial office moved to Delhi. From 2001 the journal was extended to quarterly and subsequently four issues annually have been printed out at time and regularly without fail. The journal receives manuscripts from members and non-members and cardiovascular surgeons. The manuscripts are peer reviewed by at least two or sometimes three or four reviewers who are on the panel. The manuscript process is now completely online. Funding the journal comes partially from the organization and from revenue generated by subscription and advertisement.