Prognostic nutritional index and naples prognostic score as biomarkers for the prognosis of incisional wound healing after thoracolumbar tuberculosis surgery.

OBJECTIVES

This study aimed to evaluate and compare the clinical predictive value of prognostic nutritional index (PNI) and naples prognostic score (NPS) as biomarkers for the prognosis of incisional wound healing in patients who underwent thoracolumbar tuberculosis surgery through the posterior approach.

METHODS

From January 2019 to October 2021, a total of 124 patients with thoracolumbar tuberculosis who underwent posterior approach debridement and internal fixation were included in this study. We retrospectively analyzed the clinical data, including PNI and NPS. They were divided into poor wound healing (PWH) and non-PWH groups according to whether PWH developed after the operation. And according to the receiver operating characteristic curve, patients were divided into two groups through the threshold value. Risk factors were found using logistic regression analysis.

RESULTS

The unfavorable outcome group had lower hemoglobin, serum albumin, Pre-albumin, PNI, and higher estimated blood loss, instrumented segments, neutrophil count, and NPS (P < 0.05). Both PNI and NPS were strongly correlated with PWH (r = 0.373, P < 0.05; r = -0.306, P < 0.05, respectively). The area under the curve (AUC) of PNI for predicting unfavorable outcomes was 0.764 (95% CI 0.662-0.865, P < 0.001), which was similar to NPS (0.808, 95% CI: 0.719-0.897, P < 0.001). Multivariate stepwise logistic regression analysis showed that PNI, NPS, the neutrophil count, the level of serum albumin, and the number of instrumented segments were independent risk factors for PWH.

CONCLUSION

Both PNI and NPS might be novel independent biomarkers and predictors of poor outcomes in incisional wound healing after STB surgery.