Preoperative prognostic nutritional index is an independent indicator for perioperative prognosis in coronary artery bypass grafting patients

Xueying Cui; Peiming Shen; Lei Jin; Yangyang Sun; Yilin Pan; Mengwei Lv; Lingtong Shan; Huangdong Dai; Lin Sun; Zikun Wang; Wei Li; Kaiyan Yu; Yangyang Zhang

doi:10.1016/j.nut.2023.112215

Preoperative prognostic nutritional index is an independent indicator for perioperative prognosis in coronary artery bypass grafting patients

Nutrition. 2023 Dec:116:112215. doi: 10.1016/j.nut.2023.112215. Epub 2023 Sep 5.

Authors

Xueying Cui¹, Peiming Shen², Lei Jin², Yangyang Sun³, Yilin Pan³, Mengwei Lv⁴, Lingtong Shan⁵, Huangdong Dai⁶, Lin Sun⁶, Zikun Wang⁶, Wei Li⁶, Kaiyan Yu², Yangyang Zhang⁷

Affiliations

¹ Department of Nutrition, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
² Department of Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
³ First School of Clinical Medicine, Nanjing Medical University, Nanjing, China.
⁴ Department of Cardiothoracic Surgery, The Affiliated BenQ Hospital of Nanjing Medical University, Suzhou, China.
⁵ Department of Thoracic Surgery, Sheyang County People's Hospital, Yancheng, China.
⁶ Department of Cardiovascular Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁷ Department of Cardiovascular Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: zhangyangyang_wy@vip.sina.com.

PMID: 37820569
DOI: 10.1016/j.nut.2023.112215

Abstract

Objectives: The prognostic nutritional index is widely used for surgery prognosis, but the association between preoperative prognostic nutritional index and short-term prognosis for coronary artery bypass grafting surgery and the profiles of perioperative prognostic nutritional index remain unclear.

Methods: This study retrospectively enrolled a total of 879 adult patients undergoing coronary artery bypass grafting surgery in the Shanghai Chest Hospital from 2006 to 2022. The prognostic nutritional index was calculated based on serum albumin and peripheral lymphocyte count. In-hospital mortality, demographic characteristics, blood biochemistry parameters, cardiovascular medical history, and physical examination results were collected from the hospital information system. The propensity score matching method and multivariate logistic regression were used to detect the association between preoperative prognostic nutritional index and in-hospital mortality.

Results: Patients were divided into a high-prognostic nutritional index group (n = 500) and a low-prognostic nutritional index group (n = 379), using a cutoff value of 48.1 according to receiver operating characteristic curve analysis. The propensity score matching-adjusted mean prognostic nutritional index levels decreased from 48.35 before the operation to 34.04 an in ≤24 h after the operation and rebounded to 43.36 before discharge. High preoperative prognostic nutritional index was inversely associated with in-hospital mortality for coronary artery bypass grafting surgery (odds ratio = 0.86; 95% CI, 0.77-0.97) in propensity score matching-adjusted multivariate logistic regression.

Conclusions: Preoperative prognostic nutritional index is an independent indicator for in-hospital mortality of for coronary artery bypass grafting surgery, and the variation trend of prognostic nutritional index during perioperation tends to be U-shaped.

Keywords: Coronary artery bypass grafting surgery; In-hospital mortality; Perioperative nutrition; Prognostic nutritional index; Propensity score matching study.

MeSH terms

China
Coronary Artery Bypass*
Humans
Nutrition Assessment*
Postoperative Complications
Prognosis
Retrospective Studies
Risk Factors
Treatment Outcome