Predictive value of prognostic nutritional index for recipients of heart transplantation / 中华器官移植杂志

ABSTRACT

Objective:To explore the predictive value of prognostic nutritional index(PNI)for recipients of heart transplantation.Methods:From January 2015 to December 2020, the relevant clinical data were reviewed retrospectively for 438 post-heart transplantation recipients at Union Hospital of Tongji Medical College of Huazhong University of Science and Technology.The optimal cut-off value of PNI was determined by receiver operating characteristic(ROC)curve.The inter-group differences of clinicopathologic characteristics were compared.Overall survival(OS)was calculated by Kaplan-Meier survival curve and compared by Log-rank test between two groups.The risk factors affecting OS were examined by univariate and multivariate Cox regression.Results:The optimal cut-off value of PNI was 49.3.They were assigned into two groups of low PNI(PNI≤49.3, 284 cases)and high PNI(PNI>49.3, 154 cases). As compared with high PNI group, low PNI group was significantly correlated with lower BMI, hemoglobin, neutrophil count, albumin, low-density lipoprotein, triglyceride, recipient/donor BMI ratio and recipient age and total bilirubin(all P<0.05). Cox regression multivariate analyses indicated that recipient age, waiting time, preoperative use of intra-aortic ballon pump(IABP)and lower PNI score were risk factors(all P<0.05). Kaplan-Meier survival curve revealed that OS was better in high PNI group than that in low PNI group( χ2=15.122, P<0.01). The area under the ROC curve of PNI for predicting OS was 0.603. Conclusions:PNI score upon admission is correlated positively with postoperative survival of heart transplantation patients.PNI has some predictive value for OS.When PNI score upon admission≤49.3, postoperative survival rate is relatively worse with a shorter postoperative survival.