Correlation between prognostic nutrition index and postoperative in-hospital death in patients with acute aortic dissection

Chang Wei; Wang Youlan; He Jiahong; Liu Xiaochuan; Yu Yinghong

doi:10.3760/j.issn.1673-4777.2024.01.006

Abstract：Objective To investigate the correlation between prognostic nutrition index(PNI)and postoperative in-hospital death in patients with acute type A aortic dissection(ATAAD).Methods A total of 206 ATAAD patients admitted to Department of Cardiothoracic Surgery,Guang'an Hospital,West China Hospital,Sichuan University from December 2018 to December 2022 were selected.The all-cause death of ATAAD patients within 30 d of hospitalization was analyzed,and patients were divided into death group(32 cases)and survival group(174 cases).PNI was evaluated before surgery,and clinical data were collected.Multivariate Logistic regression was used to analyze the risk factors affecting all-cause death in patients with ATAAD within 30 d of hospitalization.The value of PNI in predicting all-cause death in patients with ATAAD within 30 d of hospitalization was analyzed by receiver operating characteristic curve.Results The serum albumin,peripheral blood lymphocyte count and PNI in death group were lower than those in survival group[(26.6±2.3)g/L vs(32.0±5.2)g/L,(1.25±0.26)× 109/L vs(2.23±0.65)× 109/L,(33±4)vs(43±5)](all P＜0.05).Acute kidney injury and prolonged extracorporeal circulation were risk factors for postoperative death,and PNI was protective factor(all P＜0.05).PNI predicted all-cause death in ATAAD patients within 30 d of hospitalization with a critical value of 35.92,the area under the curve of 0.871(95％confidence interval:0.817-0.913),sensitivity of 84.37％,and specificity of 88.51％.Conclusion Preoperative PNI reduction is associated with all-cause death within 30 d of hospitalization for ATAAD.PNI can predict the risk of short-term postoperative death in patients with ATAAD.