Gaceta medica de Mexico · 2025
The Prognostic Nutritional Index predicts poor postoperative outcomes in patients undergoing video-assisted thoracic surgery for an infectious etiology.
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Rosa Jesús J Rosales-de la, López-Martínez José B, Escamilla-López Andrea, Mier-Prado María A, Hernández-Flores Luis A, Hernández-Orona Salma C, Hernández-Viedas Claudia G, Huchim-Servin Paulina E, Peña-Gómez-Portugal Emmanuel
Аннотация
BACKGROUND: The Prognostic Nutritional Index (PNI) as a prognostic tool for the postoperative outcomes in patients undergoing thoracic surgery due to an infectious etiology remains unexplored.
OBJECTIVE: To evaluate the PNI as predictor of poor postoperative outcomes in patients undergoing surgery for a thoracic infection.
MATERIAL AND METHODS: A retrospective analysis in patients undergoing VATS during January 2019 to December 2023, including 61 patients. We performed a ROC curve analysis to identify the optimal PNI cut-off value to classify the patients into groups: A high (HR) and low-risk (LR) group. Chi-square, Fisher exact, and Mann-Whitney tests were used to compare them. A multivariate analysis with Cox regression was also performed.
RESULTS: The optimal PNI cut-off value was 28.69, with AUC 0.860 (p = 0.001), sensitivity 88.9%, specificity 78.8%. 42 patients were low-risk, while 19 high-risk. There was a significant difference in 30-day mortality between groups (HR 42% vs LR 2%, p < 0.001) as well as in 30-day major complications (HR 68% vs LR 16%, p < 0.001). A multivariate analysis revealed that PNI-based risk group was an independent predictor of mortality (p = 0.008) and major complications (p < 0.001).
CONCLUSIONS: The PNI is a valid predictor of poor postoperative outcomes in patients undergoing VATS for a thoracic infection.
OBJECTIVE: To evaluate the PNI as predictor of poor postoperative outcomes in patients undergoing surgery for a thoracic infection.
MATERIAL AND METHODS: A retrospective analysis in patients undergoing VATS during January 2019 to December 2023, including 61 patients. We performed a ROC curve analysis to identify the optimal PNI cut-off value to classify the patients into groups: A high (HR) and low-risk (LR) group. Chi-square, Fisher exact, and Mann-Whitney tests were used to compare them. A multivariate analysis with Cox regression was also performed.
RESULTS: The optimal PNI cut-off value was 28.69, with AUC 0.860 (p = 0.001), sensitivity 88.9%, specificity 78.8%. 42 patients were low-risk, while 19 high-risk. There was a significant difference in 30-day mortality between groups (HR 42% vs LR 2%, p < 0.001) as well as in 30-day major complications (HR 68% vs LR 16%, p < 0.001). A multivariate analysis revealed that PNI-based risk group was an independent predictor of mortality (p = 0.008) and major complications (p < 0.001).
CONCLUSIONS: The PNI is a valid predictor of poor postoperative outcomes in patients undergoing VATS for a thoracic infection.