Prognostic nutritional index in gastrointestinal surgery

doi:10.1016/0002-9610(80)90246-9

The American Journal of Surgery

Volume 139, Issue 1, January 1980, Pages 160-167

https://doi.org/10.1016/0002-9610(80)90246-9 Get rights and content

Abstract

Based on assessment of 161 nonemergency general surgical patients, a multiparameter index of nutritional status was defined relating the risk of postoperative complications to baseline nutritional status. When applied prospectively to 100 gastrointestinal surgical patients, this index provided an accurate, quantitative estimate of operative risk, permitting rational selection of patients to receive preoperative nutritional support.

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Our analytical results indicate that elevated PNI levels are positively associated with an increased risk of NAFLD, but inversely related to the risk of AF. For robust validation of these observations, further research is required.
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The C-reactive protein (CRP)–albumin–lymphocyte (CALLY) index is a novel immuno-nutritional biomarker based on the levels of CRP, serum albumin, and lymphocyte count. This study examined the prognostic value of the CALLY index in patients with colorectal cancer undergoing curative surgery.
Between 2010 and 2017, 578 patients with stage II-III colorectal cancer who underwent curative resection were enrolled. The CALLY index was defined as (albumin × lymphocyte)/(CRP × 10⁴). We investigated the association of the CALLY index with disease-free survival (DFS) and overall survival (OS).
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An extensive search was conducted on PubMed, Embase, and Web of Science to identify relevant cohort studies. Random-effects models were employed to combine the findings, taking into account the potential influence of heterogeneity.
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The aged patients undergoing non-neurosurgery and non-cardiac surgery between January 2014 and August 2019 were included in the retrospective cohort study. The correlation between POD and PNI was investigated by univariate and multivariable logistic regression analysis, propensity score matching (PSM), inverse probability of treatment weighting (IPTW), and subgroup analysis.
In the cohort (n = 29,814), the cutoff value of PNI was 46.01 determined by the receiver operating characteristic (ROC) curve. In univariate and three multivariable regression analysis, the ORs of PNI ≤ 46.01 was 2.573(95% CI:2.261–2.929, P < 0.001),1.802 (95% CI:1.567-2.071, P < 0.001),1.463(95% CI:1.246–1.718, P < 0.001),1.370(95% CI:1.165–1.611, P < 0.001). In the PSM model and IPTW model, the ORs of PNI ≤ 46.01 were 1.424(95% CI:1.172–1.734, P < 0.001) and 1.356(95% CI:1.223–1.505, P < 0.001).
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^☆: Supported in part by Educational Grants from McGaw Laboratories, Santa Ana, California; and the McCabe Fund and Veterans Administration Medical Research Funds, Philadelphia, Pennsylvania.

^☆☆: Presented at the 20th Annual Meeting of the Society for Surgery of the Alimentary Tract, New Orleans, Louisiana, May 22–23, 1979.

¹: From the Department of Surgery, University of Pennsylvania School of Medicine, and the Philadelphia Veterans Administration Medical Center, Philadelphia, Pennsylvania.

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Scientific paperPrognostic nutritional index in gastrointestinal surgery☆,☆☆

Abstract

Am J Surg

Nutritional problems of surgical patients

Ann NY Acad Sci

Percentage of weight loss: a basic indicator of surgical risk in patients with chronic peptic ulcer

JAMA

Nutritional and metabolic assessment of the hospitalized patient

J Parent Ent Nutr

Prevalence of malnutrition in general medical patients

JAMA

Nutrition survey of a university hospital population

JPEN

Correlation of mortality with serum transferrin and anergy

JPEN

Delayed hypersensitivity: indicator of acquired failure of host defenses in sepsis and trauma

Ann Surg

Implications of malnutrition in the surgical patient

Arch Surg

Long-term total parenteral nutrition with growth, development and positive nitrogen balance

Surgery

Scientific paper
Prognostic nutritional index in gastrointestinal surgery☆,☆☆