The Prognostic Nutritional Index predicts poor postoperative outcomes in patients undergoing video-assisted thoracic surgery for an infectious etiology.

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.