ArticleBMC anesthesiology2023
Prognostic Nutritional Index (PNI) as a potential predictor and intervention target for perioperative ischemic stroke: a retrospective cohort study.
Article in BMC anesthesiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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22 citing papers in PubMed, 29 citations in OpenAlex.
- Article
- Prognostic Value of HALP and PNI Scores in Predicting 6-Month Mortality Among Geriatric Hip Fracture Patients.Medical science monitor : international medical journal of experimental and clinical research · 2026Article
- The Correlation and Predictive Value of Prognostic Nutrition Index with Vasovagal Syncope in Children.Pediatric cardiology · 2026Article
- Health status characteristics and aging determinants of centenarians in Colombia: a real-life expanded cohort profile description.BMC geriatrics · 2026Article
- Sufentanil increases delirium risk compared to fentanyl in elderly perioperative ischemic stroke patients: a retrospective cohort study.Frontiers in medicine · 2026Article
- Metabolic syndrome and the risk of perioperative ischemic stroke in non-cardiac surgery: a case-control retrospective study.Frontiers in endocrinology · 2026Article
- Article
- Textbook outcomes after splenectomy in patients with portal hypertension.Scientific reports · 2025Article
- Machine learning-based prediction of short-term outcomes in aneurysmal subarachnoid hemorrhage: a multicenter study integrating clinical and inflammatory indicators.BMC medicine · 2025Article
- Prognostic nutritional index, sarcopenia, and risk of mortality: a national population-based study.Nutrition & metabolism · 2025Article
- A model based on preoperative nutrition-inflammation score for predicting mucocutaneous separation after enterostomy in colorectal cancer patients.Scientific reports · 2025Article
- Construction of a predictive model for concurrent infection in liver failure patients based on prognostic nutritional index and inflammatory cytokine analysis.BMC gastroenterology · 2025Article
- Higher Neutrophil-to-Lymphocyte Ratio and Systemic Immune-Inflammation Index Is Associated with Better Prognosis Following Pancreaticoduodenectomy for Pancreatic Adenocarcinoma.Journal of clinical medicine · 2025Article
- Observational
- Frailty and nutritional assessments for predicting postoperative complications in older adults undergoing non-cardiac surgery.Frontiers in medicine · 2025Article
- Associations of prognostic nutritional index with cardiovascular all-cause mortality among CVD patients with diabetes or prediabetes: evidence from the NHANES 2005-2018.Frontiers in immunology · 2025Article
- Observational
- Article
- Insulin Resistance-Nutritional Index: A Simple Index and Potential Predictor of Mortality Risk in Patients with Chronic Heart Failure and Type 2 Diabetes.Diabetes, metabolic syndrome and obesity : targets and therapy · 2024Article
- The role of the prognostic nutritional index in predicting mortality in stroke patients.Revista da Associacao Medica Brasileira (1992) · 2024Observational
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14 authors at 4 institutions in 1 country.
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Abstract
backgroundThe prognostic nutritional index (PNI) is a nutritional indicator and predictor of various diseases. However it is unclear whether PNI can be a predictor of perioperative ischemic stroke. This study aims to evaluate the association of the preoperative PNI and ischemic stroke in patients undergoing non-cardiac surgery.
methodsThe retrospective cohort study included patients who underwent noncardiac surgery between January 2008 and August 2019. The patients were divided into PNI ≥ 38.8 and PNI < 38.8 groups according to the cut-off value of PNI. Univariate and multivariate logistic regression analyses were performed to explore the association between PNI and perioperative ischemic stroke. Subsequently, propensity score matching (PSM) analysis was performed to eliminate the confounding factors of covariates and further validate the results. Subgroup analyses were completed to assess the predictive utility of PNI for perioperative ischemic stroke in different groups.
resultsAmongst 221,542 hospitalized patients enrolled, 485 (0.22%) experienced an ischemic stroke within 30 days of the surgery, 22.1% of patients were malnourished according to PNI < 38.8, and the occurrence of perioperative ischemic stroke was 0.34% (169/49055) in the PNI < 38.8 group. PNI < 38.8 was significantly associated with an increased incidence of perioperative ischemic stroke whether in univariate logistic regression analysis (OR = 1.884, 95% CI: 1.559-2.267, P < 0.001) or multivariate logistic regression analysis (OR = 1.306, 95% CI: 1.061-1.602, P = 0.011). After PSM analysis, the ORs of PNI < 38.8 group were 1.250 (95% CI: 1.000-1.556, P = 0.050) and 1.357 (95% CI: 1.077-1.704, P = 0.009) in univariate logistic regression analysis and multivariate logistic regression analysis respectively. The subgroup analysis indicated that reduced PNI was significantly associated to an increased risk of perioperative ischemic stroke in patients over 65 years old, ASA II, not taking aspirin before surgery, without a history of stroke, who had neurosurgery, non-emergency surgery, and were admitted to ICU after surgery.
conclusionsOur study indicates that low preoperative PNI is significantly associated with a higher incidence of ischemic stroke in patients undergoing non-cardiac surgery. Preoperative PNI, as a preoperative nutritional status evaluation index, is an independent risk factor useful to predict perioperative ischemic stroke risk, which could be used as an intervenable preoperative clinical biochemical index to reduce the incidence of perioperative ischemic stroke.
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