Preoperative Prognostic Nutritional Index Value is Related to Postoperative Delirium in Elderly Patients After Noncardiac Surgery: A Retrospective Cohort Study
He Liu,1,2,* Mingsheng Dai,1,3,* Huilian Guan,1 Xing Gao,1 Yang Zhou,1 Xun Sun,1 Jian Zhou,1 Xiaoyi Hu,1 Xiang Li,1 Yu Song,1 Yuan Han,4 Junli Cao1,2 1Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou City 221002, Jiangsu Province, People’s Republic...
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Dove Medical Press
2021-01-01
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| Series: | Risk Management and Healthcare Policy |
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| Online Access: | https://www.dovepress.com/preoperative-prognostic-nutritional-index-value-is-related-to-postoper-peer-reviewed-article-RMHP |
| _version_ | 1818718491741519872 |
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| author | Liu H Dai M Guan H Gao X Zhou Y Sun X Zhou J Hu X Li X Song Y Han Y Cao J |
| author_facet | Liu H Dai M Guan H Gao X Zhou Y Sun X Zhou J Hu X Li X Song Y Han Y Cao J |
| author_sort | Liu H |
| collection | DOAJ |
| description | He Liu,1,2,* Mingsheng Dai,1,3,* Huilian Guan,1 Xing Gao,1 Yang Zhou,1 Xun Sun,1 Jian Zhou,1 Xiaoyi Hu,1 Xiang Li,1 Yu Song,1 Yuan Han,4 Junli Cao1,2 1Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou City 221002, Jiangsu Province, People’s Republic of China; 2Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou City 221004, Jiangsu Province, People’s Republic of China; 3Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China; 4Department of Anesthesiology, Eye & ENT Hospital of Fudan University, Shanghai 20031, People’s Republic of China*These authors contributed equally to this workCorrespondence: Junli CaoJiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, NO. 209 Tongshan Road, Yunlong District, Xuzhou City 221004, Jiangsu Province, People’s Republic of ChinaTel/Fax +86-0516-83262686Email caojl0310@aliyun.comYuan HanDepartment of Anesthesiology, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai 200031, People’s Republic of ChinaEmail hanyuan2002@163.comPurpose: Malnutrition has been considered as a risk factor for postoperative delirium (POD). The Prognostic Nutritional Index (PNI) is a validated tool for assessing nutritional status. This study aimed to investigate the association between preoperative PNI values and the occurrence of POD in elderly surgical patients.Methods: The retrospective cohort study included 361 elderly individuals who underwent noncardiac surgery between 2018 and 2019. Perioperative data were collected from the patients’ medical records. PNI was used to evaluate preoperative nutritional status. The primary outcome was the occurrence of POD. Univariate and multivariate logistic regression analyses were used to identify key factors associated with POD and assess the relationship between PNI values and the occurrence of POD. Receiver operating characteristic (ROC) curve analysis was used to assess the predictive value of PNI for POD.Results: Seventy-two (19.9%) individuals developed postoperative delirium after surgery. Compared with patients of normal nutrition status (PNI ≥ 50), mild malnutrition (PNI 45– 50) did not increase the risk of POD, while patients with moderate to severe malnutrition (PNI 40– 45) (odds ratio [OR], 2.92; 95% confidence interval [CI], 1.31– 6.50) and serious malnutrition (PNI < 40) (OR, 3.15; 95% CI, 1.12– 8.83) were more likely to develop POD. The cut-off value of PNI was 46.05 by ROC curve analysis, the area under the curve (AUC) was 0.69 (95% CI 0.62– 0.77).Conclusion: Preoperative PNI value is related to postoperative delirium in elderly patients after noncardiac surgery.Keywords: noncardiac surgery, elderly patients, nutritional status, prognostic nutritional index, postoperative delirium |
| first_indexed | 2024-12-17T19:51:54Z |
| format | Article |
| id | doaj.art-098799678a0a4cb0b578476c2bb540a6 |
| institution | Directory Open Access Journal |
| issn | 1179-1594 |
| language | English |
| last_indexed | 2024-12-17T19:51:54Z |
| publishDate | 2021-01-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Risk Management and Healthcare Policy |
| spelling | doaj.art-098799678a0a4cb0b578476c2bb540a62022-12-21T21:34:42ZengDove Medical PressRisk Management and Healthcare Policy1179-15942021-01-01Volume 141860930Preoperative Prognostic Nutritional Index Value is Related to Postoperative Delirium in Elderly Patients After Noncardiac Surgery: A Retrospective Cohort StudyLiu HDai MGuan HGao XZhou YSun XZhou JHu XLi XSong YHan YCao JHe Liu,1,2,* Mingsheng Dai,1,3,* Huilian Guan,1 Xing Gao,1 Yang Zhou,1 Xun Sun,1 Jian Zhou,1 Xiaoyi Hu,1 Xiang Li,1 Yu Song,1 Yuan Han,4 Junli Cao1,2 1Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou City 221002, Jiangsu Province, People’s Republic of China; 2Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou City 221004, Jiangsu Province, People’s Republic of China; 3Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China; 4Department of Anesthesiology, Eye & ENT Hospital of Fudan University, Shanghai 20031, People’s Republic of China*These authors contributed equally to this workCorrespondence: Junli CaoJiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, NO. 209 Tongshan Road, Yunlong District, Xuzhou City 221004, Jiangsu Province, People’s Republic of ChinaTel/Fax +86-0516-83262686Email caojl0310@aliyun.comYuan HanDepartment of Anesthesiology, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai 200031, People’s Republic of ChinaEmail hanyuan2002@163.comPurpose: Malnutrition has been considered as a risk factor for postoperative delirium (POD). The Prognostic Nutritional Index (PNI) is a validated tool for assessing nutritional status. This study aimed to investigate the association between preoperative PNI values and the occurrence of POD in elderly surgical patients.Methods: The retrospective cohort study included 361 elderly individuals who underwent noncardiac surgery between 2018 and 2019. Perioperative data were collected from the patients’ medical records. PNI was used to evaluate preoperative nutritional status. The primary outcome was the occurrence of POD. Univariate and multivariate logistic regression analyses were used to identify key factors associated with POD and assess the relationship between PNI values and the occurrence of POD. Receiver operating characteristic (ROC) curve analysis was used to assess the predictive value of PNI for POD.Results: Seventy-two (19.9%) individuals developed postoperative delirium after surgery. Compared with patients of normal nutrition status (PNI ≥ 50), mild malnutrition (PNI 45– 50) did not increase the risk of POD, while patients with moderate to severe malnutrition (PNI 40– 45) (odds ratio [OR], 2.92; 95% confidence interval [CI], 1.31– 6.50) and serious malnutrition (PNI < 40) (OR, 3.15; 95% CI, 1.12– 8.83) were more likely to develop POD. The cut-off value of PNI was 46.05 by ROC curve analysis, the area under the curve (AUC) was 0.69 (95% CI 0.62– 0.77).Conclusion: Preoperative PNI value is related to postoperative delirium in elderly patients after noncardiac surgery.Keywords: noncardiac surgery, elderly patients, nutritional status, prognostic nutritional index, postoperative deliriumhttps://www.dovepress.com/preoperative-prognostic-nutritional-index-value-is-related-to-postoper-peer-reviewed-article-RMHPnoncardiac surgeryelderly patientsnutritional statusprognostic nutritional indexpostoperative delirium |
| spellingShingle | Liu H Dai M Guan H Gao X Zhou Y Sun X Zhou J Hu X Li X Song Y Han Y Cao J Preoperative Prognostic Nutritional Index Value is Related to Postoperative Delirium in Elderly Patients After Noncardiac Surgery: A Retrospective Cohort Study Risk Management and Healthcare Policy noncardiac surgery elderly patients nutritional status prognostic nutritional index postoperative delirium |
| title | Preoperative Prognostic Nutritional Index Value is Related to Postoperative Delirium in Elderly Patients After Noncardiac Surgery: A Retrospective Cohort Study |
| title_full | Preoperative Prognostic Nutritional Index Value is Related to Postoperative Delirium in Elderly Patients After Noncardiac Surgery: A Retrospective Cohort Study |
| title_fullStr | Preoperative Prognostic Nutritional Index Value is Related to Postoperative Delirium in Elderly Patients After Noncardiac Surgery: A Retrospective Cohort Study |
| title_full_unstemmed | Preoperative Prognostic Nutritional Index Value is Related to Postoperative Delirium in Elderly Patients After Noncardiac Surgery: A Retrospective Cohort Study |
| title_short | Preoperative Prognostic Nutritional Index Value is Related to Postoperative Delirium in Elderly Patients After Noncardiac Surgery: A Retrospective Cohort Study |
| title_sort | preoperative prognostic nutritional index value is related to postoperative delirium in elderly patients after noncardiac surgery a retrospective cohort study |
| topic | noncardiac surgery elderly patients nutritional status prognostic nutritional index postoperative delirium |
| url | https://www.dovepress.com/preoperative-prognostic-nutritional-index-value-is-related-to-postoper-peer-reviewed-article-RMHP |
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