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. 2023 Aug 19;15(8):e43745.
doi: 10.7759/cureus.43745. eCollection 2023 Aug.

Impact of the Prognostic Nutritional Index on Postoperative Outcomes in Patients Undergoing Heart Surgery

Alaa A Almohammadi  1 , Maha A Alqarni  1 , Marwah Y Alqaidy  1 , Sarah A Ismail  1 , Reem M Almabadi  1
Affiliations

Impact of the Prognostic Nutritional Index on Postoperative Outcomes in Patients Undergoing Heart Surgery

Alaa A Almohammadi et al. Cureus. .

Abstract

Background Malnutrition is associated with adverse outcomes in patients undergoing cardiac surgery. The prognostic nutritional index (PNI) is a validated tool for assessing nutritional status in cardiovascular diseases. This study aims to evaluate the prognostic value of PNI in heart surgery patients, including mortality rate, length of hospital and ICU stays, and infection rate, while investigating correlations with demographic and clinical characteristics. Methods A retrospective cross-sectional study was conducted in King Fahad Armed Forces Hospital in Jeddah, Saudi Arabia. Data from electronic medical records of patients undergoing heart surgery between 2019 and 2021 were retrospectively reviewed. The study involved patients with valvular heart disease, including those requiring concomitant procedures. Statistical analysis was conducted using t-tests, logistic regression, and Kaplan-Meier survival curve analysis. Results This study included 264 individuals with a mean age of 56.48±12.11 years. The prevalence of low PNI was 50.80% and high PNI was 49.20%. No significant differences in PNI levels were found between individuals with various clinical conditions, except for target vessel revascularization. The mortality rate was slightly higher in the low PNI group, but not statistically significant. Significant differences in laboratory findings were observed between high and low PNI groups. Individuals with low PNI had longer hospital stays. Conclusion Lower PNI levels consistently correlate with longer hospital stays and higher morbidity and mortality rates, suggesting the potential importance of PNI and other nutritional markers in assessing risk and predicting outcomes in cardiac surgery patients.

Keywords: cardiovascular diseases; heart surgery; hospital; malnutrition; prognostic nutritional index (pni).

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. ROC Curve for PNI
ROC: Receiver operating characteristics; PNI: Prognostic nutritional index
Figure 2
Figure 2. Kaplan–Meier survival curve analysis of total survival across the distribution of the prognostic nutritional index (PNI; Low and High)
PNI: prognostic nutritional index, LOS: length of stay
See this image and copyright information in PMC

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