The Prognostic Nutritional Index predicts poor postoperative outcomes in patients undergoing video-assisted thoracic surgery for an infectious etiology.

IF 0.8 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

Gaceta medica de Mexico Pub Date : 2025-01-01 DOI:10.24875/GMM.24000358

Jesús J Rosales-de la Rosa, José B López-Martínez, Andrea Escamilla-López, María A Mier-Prado, Luis A Hernández-Flores, Salma C Hernández-Orona, Claudia G Hernández-Viedas, Paulina E Huchim-Servin, Emmanuel Peña-Gómez-Portugal

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引用次数: 0

Abstract

Background: The Prognostic Nutritional Index (PNI) as a prognostic tool for the postoperative outcomes in patients undergoing thoracic surgery due to an infectious etiology remains unexplored.

Objective: To evaluate the PNI as predictor of poor postoperative outcomes in patients undergoing surgery for a thoracic infection.

Material and methods: A retrospective analysis in patients undergoing VATS during January 2019 to December 2023, including 61 patients. We performed a ROC curve analysis to identify the optimal PNI cut-off value to classify the patients into groups: A high (HR) and low-risk (LR) group. Chi-square, Fisher exact, and Mann-Whitney tests were used to compare them. A multivariate analysis with Cox regression was also performed.

Results: The optimal PNI cut-off value was 28.69, with AUC 0.860 (p = 0.001), sensitivity 88.9%, specificity 78.8%. 42 patients were low-risk, while 19 high-risk. There was a significant difference in 30-day mortality between groups (HR 42% vs LR 2%, p < 0.001) as well as in 30-day major complications (HR 68% vs LR 16%, p < 0.001). A multivariate analysis revealed that PNI-based risk group was an independent predictor of mortality (p = 0.008) and major complications (p < 0.001).

Conclusions: The PNI is a valid predictor of poor postoperative outcomes in patients undergoing VATS for a thoracic infection.

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预后营养指数预测了感染性胸外科手术患者术后不良的预后。

背景：预后营养指数（PNI）作为感染性胸外科手术患者术后预后的预测工具仍未被探索。目的：评价PNI作为胸部感染手术患者术后不良预后的预测指标。材料与方法：对2019年1月至2023年12月接受VATS治疗的61例患者进行回顾性分析。我们进行了ROC曲线分析，以确定最佳PNI截断值，将患者分为高（HR）和低（LR）组。使用卡方检验、Fisher精确检验和Mann-Whitney检验对它们进行比较。采用Cox回归进行多变量分析。结果：最佳PNI临界值为28.69，AUC为0.860 (p = 0.001)，敏感性为88.9%，特异性为78.8%。低危42例，高危19例。两组间30天死亡率（HR 42% vs LR 2%, p < 0.001）以及30天主要并发症（HR 68% vs LR 16%, p < 0.001）均有显著差异。多因素分析显示，pni风险组是死亡率（p = 0.008）和主要并发症（p < 0.001）的独立预测因子。结论：PNI是胸部感染患者行VATS术后不良预后的有效预测指标。

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

Gaceta medica de Mexico 医学-医学：内科

CiteScore

1.00

自引率

0.00%

发文量

216

审稿时长

6-12 weeks

期刊介绍： Gaceta Médica de México México is the official scientific journal of the Academia Nacional de Medicina de México, A.C. Its goal is to contribute to health professionals by publishing the most relevant progress both in research and clinical practice. Gaceta Médica de México is a bimonthly peer reviewed journal, published both in paper and online in open access, both in Spanish and English. It has a brilliant editorial board formed by national and international experts.