Association between nutritional status scores and the 30-day mortality in patients with acute kidney injury: an analysis of MIMIC-III database
Abstract Background Studies have proven that the risk of acute kidney injury (AKI) increased in patients with malnutrition. Prognostic nutritional index (PNI) and geriatric nutritional risk index (GNRI) were general tools to predict the risk of mortality, but the prognostic value of them for in-hosp...
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | BMC Nephrology |
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| Online Access: | https://doi.org/10.1186/s12882-023-03329-5 |
| _version_ | 1797577524026277888 |
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| author | Tingting Gao Xueyuan Yu |
| author_facet | Tingting Gao Xueyuan Yu |
| author_sort | Tingting Gao |
| collection | DOAJ |
| description | Abstract Background Studies have proven that the risk of acute kidney injury (AKI) increased in patients with malnutrition. Prognostic nutritional index (PNI) and geriatric nutritional risk index (GNRI) were general tools to predict the risk of mortality, but the prognostic value of them for in-hospital mortality among patients with AKI have not been validated yet. Herein, this study aims to explore the association between PNI and GNRI and 30-day mortality in patients with AKI. Methods Demographic and clinical data of 863 adult patients with AKI were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database in 2001–2012 in this retrospective cohort study. Univariate and multivariate Cox proportional regression analyses were used to explore the association between PNI and GNRI and 30-day mortality. The evaluation indexes were hazard ratios (HRs) and 95% confidence intervals (CIs). Subgroup analyses of age, Sequential Organ Failure Assessment (SOFA) score and Simplified Acute Physiology (SAPS-II) score were also performed. Results Totally, 222 (26.71%) patients died within 30 days. After adjusting for covariates, PNI ≥ 28.5 [HR = 0.71, 95%CI: (0.51–0.98)] and GNRI ≥ 83.25 [HR = 0.63, 95%CI: (0.47–0.86)] were both associated with low risk of 30-day mortality. These relationships were also found in patients who aged ≥ 65 years old. Differently, high PNI level was associated with low risk of 30-day mortality among patients with SOFA score < 6 or SAPS-II score < 43, while high GNRI was associated with low risk of 30-day mortality among those who with SOFA score ≥ 6 or SAPS-II score ≥ 43 (all P < 0.05). Conclusion PNI and GNRI may be potential predictors of 30-day mortality in patients with AKI. Whether the PNI is more recommended for patients with mild AKI, while GNRI for those with severe AKI is needed further exploration. |
| first_indexed | 2024-03-10T22:09:32Z |
| format | Article |
| id | doaj.art-987f4f28ff6540b39ca9bab54bde7562 |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-03-10T22:09:32Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-987f4f28ff6540b39ca9bab54bde75622023-11-19T12:39:25ZengBMCBMC Nephrology1471-23692023-10-0124111010.1186/s12882-023-03329-5Association between nutritional status scores and the 30-day mortality in patients with acute kidney injury: an analysis of MIMIC-III databaseTingting Gao0Xueyuan Yu1Department of Comprehensive Medical, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical UniversityDepartment of Nephrology, Qi Lu Hospital of Shandong UniversityAbstract Background Studies have proven that the risk of acute kidney injury (AKI) increased in patients with malnutrition. Prognostic nutritional index (PNI) and geriatric nutritional risk index (GNRI) were general tools to predict the risk of mortality, but the prognostic value of them for in-hospital mortality among patients with AKI have not been validated yet. Herein, this study aims to explore the association between PNI and GNRI and 30-day mortality in patients with AKI. Methods Demographic and clinical data of 863 adult patients with AKI were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database in 2001–2012 in this retrospective cohort study. Univariate and multivariate Cox proportional regression analyses were used to explore the association between PNI and GNRI and 30-day mortality. The evaluation indexes were hazard ratios (HRs) and 95% confidence intervals (CIs). Subgroup analyses of age, Sequential Organ Failure Assessment (SOFA) score and Simplified Acute Physiology (SAPS-II) score were also performed. Results Totally, 222 (26.71%) patients died within 30 days. After adjusting for covariates, PNI ≥ 28.5 [HR = 0.71, 95%CI: (0.51–0.98)] and GNRI ≥ 83.25 [HR = 0.63, 95%CI: (0.47–0.86)] were both associated with low risk of 30-day mortality. These relationships were also found in patients who aged ≥ 65 years old. Differently, high PNI level was associated with low risk of 30-day mortality among patients with SOFA score < 6 or SAPS-II score < 43, while high GNRI was associated with low risk of 30-day mortality among those who with SOFA score ≥ 6 or SAPS-II score ≥ 43 (all P < 0.05). Conclusion PNI and GNRI may be potential predictors of 30-day mortality in patients with AKI. Whether the PNI is more recommended for patients with mild AKI, while GNRI for those with severe AKI is needed further exploration.https://doi.org/10.1186/s12882-023-03329-5AKIPNIGNRISOFASAPS-II30-day mortality |
| spellingShingle | Tingting Gao Xueyuan Yu Association between nutritional status scores and the 30-day mortality in patients with acute kidney injury: an analysis of MIMIC-III database BMC Nephrology AKI PNI GNRI SOFA SAPS-II 30-day mortality |
| title | Association between nutritional status scores and the 30-day mortality in patients with acute kidney injury: an analysis of MIMIC-III database |
| title_full | Association between nutritional status scores and the 30-day mortality in patients with acute kidney injury: an analysis of MIMIC-III database |
| title_fullStr | Association between nutritional status scores and the 30-day mortality in patients with acute kidney injury: an analysis of MIMIC-III database |
| title_full_unstemmed | Association between nutritional status scores and the 30-day mortality in patients with acute kidney injury: an analysis of MIMIC-III database |
| title_short | Association between nutritional status scores and the 30-day mortality in patients with acute kidney injury: an analysis of MIMIC-III database |
| title_sort | association between nutritional status scores and the 30 day mortality in patients with acute kidney injury an analysis of mimic iii database |
| topic | AKI PNI GNRI SOFA SAPS-II 30-day mortality |
| url | https://doi.org/10.1186/s12882-023-03329-5 |
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