Araştırma Makalesi
Can the prognostic nutritional index be used as an indicator of mortality in patients with acute ischemic stroke?
Öz
Objective: It is known that malnutrition in acute ischemic stroke(AIS) patients is closely related to poor prognosis. The clinical and prognostic significance of the prognostic nutritional index (PNI), defined by Onodera et al, in patients with AIS has not yet been exhibited clearly. For this reason, our aim in this study is to determine the effect of PNI on short-term mortality of patients with AIS.
Method: Our study was a single-centered retrospective study. The patient group consisted of 452 patients who were referred to our clinic within the first 24 h of symptoms and diagnosed with AIS between January 2010-2020. The patient and control groups were compared in terms of albumin, lymphocyte count(LC) and PNI levels.
Results: Albumin, LC and PNI levels were lower in the patient group. Then the patient group was divided into two subgroups according to 30-day mortality [the first group (surviving patients(n=351)), the second group(exitus within 30 days after AIS(n=101))]. When these two groups were compared in terms of LC, albumin and PNI levels, the LC, albumin and PNI levels were found lower in the second group(p<0.05). A multivariate analysis to determine the risk factors associated with 30-day mortality after AIS revealed that uric acid and PNI were independent variables. Operating characteristic curve analysis also showed that values below 48 for PNI could be used with high sensitivity and specificity in detecting 30-day mortality due to AIS.
Conclusions: This study showed that low PNI levels was closely associated with short-term mortality after AIS. Based on these results, it can be concluded that PNI levels may be regarded as a new indicator for determining post-AIS prognosis. More detailed and extensive prospective studies in this regard are needed in the future.
Anahtar Kelimeler
malnutrition acute ischemic stroke mortality prognostic nutritional index
Proje Numarası
Yok
Kaynakça
- 1. Miller EL, Murray L, Richards L, Zorowitz RD, Bakas T, Clark P, Billinger SA. Comprehensive overview of nursing and interdisciplinary rehabilitation care of the stroke patient: a scientific statement from the American Heart Association. Stroke 2010; 41(10): 2402-48.
- 2. Ryu WS, Lee SH, Kim CK, Kim BJ, Yoon BW. Body mass index, initial neurological severity and long-term mortality in ischemic stroke. Cerebrovascular Diseases 2011; 32(2): 170-6.
- 3. Fock RA, Blatt SL, Beutler B, Pereira J, Tsujita M, de Barros FEV, Borelli P. Study of lymphocyte subpopulations in bone marrow in a model of protein–energy malnutrition. Nutrition 2010; 26(10): 1021-8.
- 4. Rocha NP, Fortes RC. Total lymphocyte count and serum albumin as predictors of nutritional risk in surgical patients. ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)2015; 28(3): 193-6. 5. Zhang Z, Pereira SL, Luo M, Matheson EM. Evaluation of blood biomarkers associated with risk of malnutrition in older adults: A systematic review and meta-analysis. Nutrients 2017; 9(8):829.
- 6. Blackburn GL, Bistrian BR, Maini BS, Schlamm HT, Smith MF. Nutritional and metabolic assessment of the hospitalized patient. Journal of parenteral and enteral nutrition 1977; 1(1): 11-21.
- 7. Onodera T, Goseki N, Kosaki G. Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients. Nihon Geka Gakkai Zasshi 1984; 85(9);1001-5.
- 8. Periša V, Zibar L, Knezović A, Periša I, Sinčić-Petričević J, Aurer I. Prognostic nutritional index as a predictor of prognosis in patients with diffuse large B cell lymphoma. Wiener klinische Wochenschrift 2017; 129(11-12):411-9.
- 9. Sun K, Chen S, Xu J, Li G, He Y. The prognostic significance of the prognostic nutritional index in cancer: a systematic review and meta-analysis. Journal of cancer research and clinical oncology 2014; 140(9): 1537-49.
- 10. Okada S, Shimada J, Kato D, Tsunezuka H, Teramukai S, Inoue M. Clinical significance of prognostic nutritional index after surgical treatment in lung cancer. The Annals of thoracic surgery 2017; 104(1): 296-302.
- 11. Yang Y, Gao P, Chen X, Song Y, Shi J, Zhao J, Wang Z. Prognostic significance of preoperative prognostic nutritional index in colorectal cancer: results from a retrospective cohort study and a meta-analysis. Oncotarget 2016;7(36): 58543.
- 12. Lee JY, Kim HI, Kim YN, Hong JH, Alshomimi S, An JY, Kim CB. Clinical significance of the prognostic nutritional index for predicting short-and long-term surgical outcomes after gastrectomy: a retrospective analysis of 7781 gastric cancer patients. Medicine 2016; 95(18).
- 13. Lee SH, Chung MJ, Kim B, Lee HS, Lee HJ, Heo, JY, Song SY. The Significance of the Prognostic Nutritional Index for All Stages of Pancreatic Cancer. Nutrition and cancer 2017; 69(3):512-9.
- 14. Korfali G, Gündoğdu H, Aydintug S, Bahar M, Besler T, Moral AR. (2009). Nutritional risk of hospitalized patients in Turkey. Clin Nutr 2009; 28: 533-7.
- 15. Meakins J. Therapeutic approaches to anergy in surgical patients: Surgery and levamisole. Ann Surg 1979; 190: 286-8.
- 16. Xiang W, Chen X, Ye W, Li J, Zhang X, Xie D. Prognostic nutritional index for predicting 3-month outcomes in ischemic stroke patients undergoing thrombolysis. Frontiers in Neurology 2020; 11: 599-603.
Yıl 2020,
Cilt: 42 Sayı: 4, 484 - 490, 31.12.2020
Öz
Destekleyen Kurum
Yok
Proje Numarası
Yok
Teşekkür
Yok
Kaynakça
- 1. Miller EL, Murray L, Richards L, Zorowitz RD, Bakas T, Clark P, Billinger SA. Comprehensive overview of nursing and interdisciplinary rehabilitation care of the stroke patient: a scientific statement from the American Heart Association. Stroke 2010; 41(10): 2402-48.
- 2. Ryu WS, Lee SH, Kim CK, Kim BJ, Yoon BW. Body mass index, initial neurological severity and long-term mortality in ischemic stroke. Cerebrovascular Diseases 2011; 32(2): 170-6.
- 3. Fock RA, Blatt SL, Beutler B, Pereira J, Tsujita M, de Barros FEV, Borelli P. Study of lymphocyte subpopulations in bone marrow in a model of protein–energy malnutrition. Nutrition 2010; 26(10): 1021-8.
- 4. Rocha NP, Fortes RC. Total lymphocyte count and serum albumin as predictors of nutritional risk in surgical patients. ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)2015; 28(3): 193-6. 5. Zhang Z, Pereira SL, Luo M, Matheson EM. Evaluation of blood biomarkers associated with risk of malnutrition in older adults: A systematic review and meta-analysis. Nutrients 2017; 9(8):829.
- 6. Blackburn GL, Bistrian BR, Maini BS, Schlamm HT, Smith MF. Nutritional and metabolic assessment of the hospitalized patient. Journal of parenteral and enteral nutrition 1977; 1(1): 11-21.
- 7. Onodera T, Goseki N, Kosaki G. Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients. Nihon Geka Gakkai Zasshi 1984; 85(9);1001-5.
- 8. Periša V, Zibar L, Knezović A, Periša I, Sinčić-Petričević J, Aurer I. Prognostic nutritional index as a predictor of prognosis in patients with diffuse large B cell lymphoma. Wiener klinische Wochenschrift 2017; 129(11-12):411-9.
- 9. Sun K, Chen S, Xu J, Li G, He Y. The prognostic significance of the prognostic nutritional index in cancer: a systematic review and meta-analysis. Journal of cancer research and clinical oncology 2014; 140(9): 1537-49.
- 10. Okada S, Shimada J, Kato D, Tsunezuka H, Teramukai S, Inoue M. Clinical significance of prognostic nutritional index after surgical treatment in lung cancer. The Annals of thoracic surgery 2017; 104(1): 296-302.
- 11. Yang Y, Gao P, Chen X, Song Y, Shi J, Zhao J, Wang Z. Prognostic significance of preoperative prognostic nutritional index in colorectal cancer: results from a retrospective cohort study and a meta-analysis. Oncotarget 2016;7(36): 58543.
- 12. Lee JY, Kim HI, Kim YN, Hong JH, Alshomimi S, An JY, Kim CB. Clinical significance of the prognostic nutritional index for predicting short-and long-term surgical outcomes after gastrectomy: a retrospective analysis of 7781 gastric cancer patients. Medicine 2016; 95(18).
- 13. Lee SH, Chung MJ, Kim B, Lee HS, Lee HJ, Heo, JY, Song SY. The Significance of the Prognostic Nutritional Index for All Stages of Pancreatic Cancer. Nutrition and cancer 2017; 69(3):512-9.
- 14. Korfali G, Gündoğdu H, Aydintug S, Bahar M, Besler T, Moral AR. (2009). Nutritional risk of hospitalized patients in Turkey. Clin Nutr 2009; 28: 533-7.
- 15. Meakins J. Therapeutic approaches to anergy in surgical patients: Surgery and levamisole. Ann Surg 1979; 190: 286-8.
- 16. Xiang W, Chen X, Ye W, Li J, Zhang X, Xie D. Prognostic nutritional index for predicting 3-month outcomes in ischemic stroke patients undergoing thrombolysis. Frontiers in Neurology 2020; 11: 599-603.
Toplam 15 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Medical Science Research Makaleler |
| Yazarlar | |
| Proje Numarası | Yok |
| Yayımlanma Tarihi | 31 Aralık 2020 |
| Kabul Tarihi | 17 Aralık 2020 |
| Yayımlandığı Sayı | Yıl 2020Cilt: 42 Sayı: 4 |