PDF(Pubmed)
Abstract：
UNASSIGNED: The survival of critically ill patients with acute kidney injury (AKI) undergoing continuous renal replacement therapy (CRRT) is highly dependent on their nutritional status.
UNASSIGNED: The prognostic nutritional index (PNI) is an indicator used to assess nutritional status and is calculated as: PNI = (serum albumin in g/dL) × 10 + (total lymphocyte count in/mm3) × 0.005. In this retrospective study, we investigated the correlation between this index and clinical outcomes in critically ill patients with AKI receiving CRRT.
UNASSIGNED: We analyzed data from 2076 critically ill patients admitted to the intensive care unit at Changhua Christian Hospital, a tertiary hospital in central Taiwan, between January 1, 2010, and April 30, 2021. All these patients met the inclusion criteria of the study. The relationship between PNI and renal replacement therapy-free survival (RRTFS) and mortality was examined using logistic regression models, Cox proportional hazard models, and propensity score matching. High utilization rate of parenteral nutrition (PN) was observed in our study. Subgroup analysis was performed to explore the interaction effect between PNI and PN on mortality.
UNASSIGNED: Patients with higher PNI levels exhibited a greater likelihood of achieving RRTFS, with an adjusted odds ratio of 2.43 (95% confidence interval [CI]: 1.98-2.97, p-value < 0.001). Additionally, these patients demonstrated higher survival rates, with an adjusted hazard ratio of 0.84 (95% CI: 0.72-0.98) for 28-day mortality and 0.80 (95% CI: 0.69-0.92) for 90-day mortality (all p-values < 0.05), compared to those in the low PNI group. While a high utilization rate of parenteral nutrition (PN) was observed, with 78.86% of CRRT patients receiving PN, subgroup analysis showed that high PNI had an independent protective effect on mortality outcomes in AKI patients receiving CRRT, regardless of their PN status.
UNASSIGNED: PNI can serve as an easy, simple, and efficient measure of lymphocytes and albumin levels to predict RRTFS and mortality in AKI patients with require CRRT.
UNASSIGNED: The prognostic nutritional index (PNI) is an indicator used to assess nutritional status and is calculated as: PNI = (serum albumin in g/dL) × 10 + (total lymphocyte count in/mm3) × 0.005. In this retrospective study, we investigated the correlation between this index and clinical outcomes in critically ill patients with AKI receiving CRRT.
UNASSIGNED: We analyzed data from 2076 critically ill patients admitted to the intensive care unit at Changhua Christian Hospital, a tertiary hospital in central Taiwan, between January 1, 2010, and April 30, 2021. All these patients met the inclusion criteria of the study. The relationship between PNI and renal replacement therapy-free survival (RRTFS) and mortality was examined using logistic regression models, Cox proportional hazard models, and propensity score matching. High utilization rate of parenteral nutrition (PN) was observed in our study. Subgroup analysis was performed to explore the interaction effect between PNI and PN on mortality.
UNASSIGNED: Patients with higher PNI levels exhibited a greater likelihood of achieving RRTFS, with an adjusted odds ratio of 2.43 (95% confidence interval [CI]: 1.98-2.97, p-value < 0.001). Additionally, these patients demonstrated higher survival rates, with an adjusted hazard ratio of 0.84 (95% CI: 0.72-0.98) for 28-day mortality and 0.80 (95% CI: 0.69-0.92) for 90-day mortality (all p-values < 0.05), compared to those in the low PNI group. While a high utilization rate of parenteral nutrition (PN) was observed, with 78.86% of CRRT patients receiving PN, subgroup analysis showed that high PNI had an independent protective effect on mortality outcomes in AKI patients receiving CRRT, regardless of their PN status.
UNASSIGNED: PNI can serve as an easy, simple, and efficient measure of lymphocytes and albumin levels to predict RRTFS and mortality in AKI patients with require CRRT.
摘要：
■接受连续性肾脏替代治疗（CRRT）的急性肾损伤（AKI）危重患者的生存率高度依赖于其营养状况。
■预后营养指数（PNI）是用于评估营养状况的指标，其计算公式为：PNI=（以g/dL为单位的血清白蛋白）×10（以/mm3为单位的总淋巴细胞计数）×0.005。在这项回顾性研究中,在接受CRRT治疗的AKI危重患者中,我们调查了该指标与临床结局之间的相关性.
■我们分析了彰化基督教医院重症监护室收治的2076名危重病人的数据,台湾中部的一家三级医院，2010年1月1日至2021年4月30日之间。所有这些患者均符合研究的纳入标准。使用logistic回归模型检查PNI与无肾脏替代治疗生存率（RRTFS）和死亡率之间的关系，Cox比例风险模型，和倾向得分匹配。在我们的研究中观察到肠外营养（PN）的高利用率。进行亚组分析以探讨PNI和PN对死亡率的交互作用。
■PNI水平较高的患者表现出更大的实现RRTFS的可能性，调整后的比值比为2.43（95%置信区间[CI]：1.98-2.97，p值<0.001）。此外,这些患者表现出更高的生存率，28天死亡率的校正风险比为0.84（95％CI：0.72-0.98），90天死亡率为0.80（95％CI：0.69-0.92）（所有p值<0.05），与低PNI组相比。虽然观察到肠外营养（PN）的高利用率，78.86%的CRRT患者接受PN，亚组分析显示，高PNI对接受CRRT的AKI患者的死亡结局有独立的保护作用，不管他们的PN状态如何。
■PNI可以作为一个简单的，简单,以及淋巴细胞和白蛋白水平的有效测量，以预测需要CRRT的AKI患者的RRTFS和死亡率。
■预后营养指数（PNI）是用于评估营养状况的指标，其计算公式为：PNI=（以g/dL为单位的血清白蛋白）×10（以/mm3为单位的总淋巴细胞计数）×0.005。在这项回顾性研究中,在接受CRRT治疗的AKI危重患者中,我们调查了该指标与临床结局之间的相关性.
■我们分析了彰化基督教医院重症监护室收治的2076名危重病人的数据,台湾中部的一家三级医院，2010年1月1日至2021年4月30日之间。所有这些患者均符合研究的纳入标准。使用logistic回归模型检查PNI与无肾脏替代治疗生存率（RRTFS）和死亡率之间的关系，Cox比例风险模型，和倾向得分匹配。在我们的研究中观察到肠外营养（PN）的高利用率。进行亚组分析以探讨PNI和PN对死亡率的交互作用。
■PNI水平较高的患者表现出更大的实现RRTFS的可能性，调整后的比值比为2.43（95%置信区间[CI]：1.98-2.97，p值<0.001）。此外,这些患者表现出更高的生存率，28天死亡率的校正风险比为0.84（95％CI：0.72-0.98），90天死亡率为0.80（95％CI：0.69-0.92）（所有p值<0.05），与低PNI组相比。虽然观察到肠外营养（PN）的高利用率，78.86%的CRRT患者接受PN，亚组分析显示，高PNI对接受CRRT的AKI患者的死亡结局有独立的保护作用，不管他们的PN状态如何。
■PNI可以作为一个简单的，简单,以及淋巴细胞和白蛋白水平的有效测量，以预测需要CRRT的AKI患者的RRTFS和死亡率。
