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The relationship between prognostic nutritional index and mortality in geriatric COVID-19 patients

Year 2023, , 241 - 245, 28.06.2023
https://doi.org/10.47582/jompac.1288909

Abstract

Aims: The aim of this study is to examine the relationship between prognostic nutritional index (PNI) and mortality in geriatric patients who admitted to hospital due to COVID-19.
Methods: In this retrospective cohort study, geriatric patients admitted to the emergency department of a tertiary hospital and hospitalized for COVID-19 were examined. Demographic data, laboratory results, in-hospital mortality status of the patients were recorded. The relationship between PNI values and in-hospital mortality was analyzed.
Results: The study was completed with 316 patients whose data were fully accessible. The mean age of the patients was 77.3±7.9 years and 167 (52.8%) were male. When the cut-off value of PNI level in identifying in-hospital mortality was≤42, the sensitivity was 92.3%, the specificity was 44.9%, and the positive predictive value was 57.5 and the negative predictive value was 87.8
Conclusion: This study demonstrates the prognostic importance of PNI in geriatric COVID-19 patients. Low PNI values were associated with higher in-hospital mortality rate. The use of PNI can be considered an important tool in evaluating the COVID-19 prognosis of elderly patients and developing more individualized treatment strategies.

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References

  • Chams N, Chams S, Badran R, et al. COVID-19: a multidisciplinary review. Front Public Health. 2020;8:383. doi:10.3389/fpubh.2020.00383
  • Ak R, Kurt E, Bahadirli S. Comparison of 2 risk prediction models specific for COVID-19: the brescia-COVID respiratory severity scale versus the quick COVID-19 severity index. Disaster Med Public Health Prep. 2021;15(4):e46-e50. doi:10.1017/dmp.2021.141
  • Karcıoglu O, Yilmaz S, Kilic M et al. Geriatric sepsis in the COVID-19 era: challenges in diagnosis and management. Int J Pharm Res Allied Sci 2022;11:123-133. doi: 10.51847/leeeQUPlat
  • Bistrian BR, Blackburn GL, Vitale J, Cochran D, Naylor J. Prevalence of malnutrition in general medical patients. JAMA. 1976;235(15):1567-1570.
  • Weimann A, Braga M, Carli F, et al. ESPEN practical guideline: clinical nutrition in surgery. Clin Nutr. 2021;40(7):4745-4761. doi:10.1016/j.clnu.2021.03.031
  • Kaegi-Braun N, Mueller M, Schuetz P, Mueller B, Kutz A. Evaluation of nutritional support and in-hospital mortality in patients with malnutrition. JAMA Netw Open. 2021;4(1):e2033433. doi:10.1001/jamanetworkopen.2020.33433
  • Cadwell JB, Afonso AM, Shahrokni A. Prognostic nutritional index (PNI), independent of frailty is associated with six-month postoperative mortality. J Geriatr Oncol. 2020;11(5):880-884. doi:10.1016/j.jgo.2020.03.013
  • Li H, Cen K, Sun W, Feng B. Prognostic value of geriatric nutritional risk index in elderly patients with heart failure: a meta-analysis. Aging Clin Exp Res. 2021;33(6):1477-1486. doi:10.1007/s40520-020-01656-3
  • Mungmunpuntipantip R, Wiwanitkit V. Prognostic nutritional index, immune nutritional status and COVID-19. Int J Vitam Nutr Res. 2022;92(1):3. doi:10.1024/0300-9831/a000737
  • Lidoriki I, Frountzas M, Schizas D. Could nutritional and functional status serve as prognostic factors for COVID-19 in the elderly? Med Hypotheses. 2020;144:109946. doi:10.1016/j.mehy.2020.109946
  • World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191-2194. doi: 10.1001/jama.2013.281053
  • Seyhan AU, Doğanay F, Yılmaz E, Aydıner Ö, Ak R, Demir Tekol S. The comparison of chest CT and RT-PCR during the diagnosis of COVID-19. J Clin Med Kaz. 2021;18:53-56. doi: 10.23950/jcmk/9656
  • Bilim Kurulu Çalışması. COVID-19 (SARS-CoV-2 enfeksiyonu) Rehberi. TC. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü (2 Nisan 2020) Ankara. 2020. Available at: https://covid19rehberi.com/wp/content/uploads/2020/04/COVID19_Eriskin_Hasta_Tedavisi_02042020.pdf Accessed February 20, 2021.
  • Ak R, Doğanay F. Comparison of 4 different threshold values of shock index in predicting mortality of COVID-19 patients. Disaster Med Public Health Prep. 2021;17:e99. doi:10.1017/dmp. 2021.374
  • Hu X, Deng H, Wang Y, Chen L, Gu X, Wang X. Predictive value of the prognostic nutritional index for the severity of coronavirus disease 2019. Nutrition. 2021;84:111123. doi:10.1016/j.nut.2020.111123
  • Hung KC, Ko CC, Wang LK, et al. Association of prognostic nutritional index with severity and mortality of hospitalized patients with COVID-19: a systematic review and meta-analysis. Diagnostics (Basel). 2022;12(7):1515. doi:10.3390/diagnostics12071515
  • Wang ZH, Lin YW, Wei XB, et al. Predictive value of prognostic nutritional index on COVID-19 severity. Front Nutr. 2021;7:582736. doi:10.3389/fnut.2020.582736
  • Wang R, He M, Yin W, et al. The Prognostic Nutritional Index is associated with mortality of COVID-19 patients in Wuhan, China. J Clin Lab Anal. 2020;34(10):e23566. doi:10.1002/jcla.23566
  • Yılmaz E, Ak R, Doğanay F. Usefulness of the neutrophil-to-lymphocyte ratio in predicting the severity of COVID-19 patients: a retrospective cohort study. Sao Paulo Med J. 2022;140(1):81-86. doi:10.1590/1516-3180.2021.0298.R1.27052021
  • Ak R, Doğanay F, Yilmaz E. Comparison of C-reactive protein and C-reactive protein-to-albumin ratio in predicting mortality among geriatric coronavirus disease 2019 patients. Rev Assoc Med Bras (1992). 2022;68(1):82-86. doi:10.1590/1806-9282.20210811
  • Aziz M, Fatima R, Lee-Smith W, Assaly R. The association of low serum albumin level with severe COVID-19: a systematic review and meta-analysis. Crit Care. 2020;24(1):255. doi:10.1186/s13054 -020-02995-3

Geriatrik COVID-19 hastalarında prognostik beslenme indeksi ile mortalite arasındaki ilişki

Year 2023, , 241 - 245, 28.06.2023
https://doi.org/10.47582/jompac.1288909

Abstract

Amaç: Bu çalışmanın amacı, COVID-19 nedeniyle hastaneye başvuran geriatrik hastalarda prognostik beslenme indeksi ile mortalite arasındaki ilişkiyi incelemektir.
Gereç ve Yöntem: Bu retrospektif kohort çalışmada, üçüncü basamak bir hastanenin acil servisine başvuran ve COVID-19 nedeniyle hastaneye yatırılan geriatrik hastalar incelenmiştir. Hastaların demografik verileri, laboratuvar sonuçları, hastane içi mortalite durumları kaydedildi. PNI değerleri ile hastane içi mortalite arasındaki ilişki analiz edildi.
Bulgular: Verileri tamamen erişilebilir olan 316 hasta ile çalışma tamamlandı. Hastaların ortalama yaşı 77,3±7,9 idi ve 167'si (%52,8) erkekti. PNI düzeyinin hastane içi mortaliteyi belirlemede cut-off değeri ≤42 olduğunda sensitivitesi %92,3, spesifitesi %44,9, pozitif prediktif değeri 57,5 ve negatif prediktif değeri 87,8'dir.
Sonuç: Bu çalışma geriatrik COVID-19 hastalarında PNI'nin prognostik önemini göstermektedir. Düşük PNI değerleri hastane içi ölüm oranı ile ilişkilendirilmiştir. PNI kullanımı, yaşlı hastaların COVID-19 prognozunun değerlendirilmesinde ve daha bireyselleştirilmiş tedavi stratejilerinin geliştirilmesinde önemli bir araç olarak kabul edilebilir.

Project Number

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References

  • Chams N, Chams S, Badran R, et al. COVID-19: a multidisciplinary review. Front Public Health. 2020;8:383. doi:10.3389/fpubh.2020.00383
  • Ak R, Kurt E, Bahadirli S. Comparison of 2 risk prediction models specific for COVID-19: the brescia-COVID respiratory severity scale versus the quick COVID-19 severity index. Disaster Med Public Health Prep. 2021;15(4):e46-e50. doi:10.1017/dmp.2021.141
  • Karcıoglu O, Yilmaz S, Kilic M et al. Geriatric sepsis in the COVID-19 era: challenges in diagnosis and management. Int J Pharm Res Allied Sci 2022;11:123-133. doi: 10.51847/leeeQUPlat
  • Bistrian BR, Blackburn GL, Vitale J, Cochran D, Naylor J. Prevalence of malnutrition in general medical patients. JAMA. 1976;235(15):1567-1570.
  • Weimann A, Braga M, Carli F, et al. ESPEN practical guideline: clinical nutrition in surgery. Clin Nutr. 2021;40(7):4745-4761. doi:10.1016/j.clnu.2021.03.031
  • Kaegi-Braun N, Mueller M, Schuetz P, Mueller B, Kutz A. Evaluation of nutritional support and in-hospital mortality in patients with malnutrition. JAMA Netw Open. 2021;4(1):e2033433. doi:10.1001/jamanetworkopen.2020.33433
  • Cadwell JB, Afonso AM, Shahrokni A. Prognostic nutritional index (PNI), independent of frailty is associated with six-month postoperative mortality. J Geriatr Oncol. 2020;11(5):880-884. doi:10.1016/j.jgo.2020.03.013
  • Li H, Cen K, Sun W, Feng B. Prognostic value of geriatric nutritional risk index in elderly patients with heart failure: a meta-analysis. Aging Clin Exp Res. 2021;33(6):1477-1486. doi:10.1007/s40520-020-01656-3
  • Mungmunpuntipantip R, Wiwanitkit V. Prognostic nutritional index, immune nutritional status and COVID-19. Int J Vitam Nutr Res. 2022;92(1):3. doi:10.1024/0300-9831/a000737
  • Lidoriki I, Frountzas M, Schizas D. Could nutritional and functional status serve as prognostic factors for COVID-19 in the elderly? Med Hypotheses. 2020;144:109946. doi:10.1016/j.mehy.2020.109946
  • World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191-2194. doi: 10.1001/jama.2013.281053
  • Seyhan AU, Doğanay F, Yılmaz E, Aydıner Ö, Ak R, Demir Tekol S. The comparison of chest CT and RT-PCR during the diagnosis of COVID-19. J Clin Med Kaz. 2021;18:53-56. doi: 10.23950/jcmk/9656
  • Bilim Kurulu Çalışması. COVID-19 (SARS-CoV-2 enfeksiyonu) Rehberi. TC. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü (2 Nisan 2020) Ankara. 2020. Available at: https://covid19rehberi.com/wp/content/uploads/2020/04/COVID19_Eriskin_Hasta_Tedavisi_02042020.pdf Accessed February 20, 2021.
  • Ak R, Doğanay F. Comparison of 4 different threshold values of shock index in predicting mortality of COVID-19 patients. Disaster Med Public Health Prep. 2021;17:e99. doi:10.1017/dmp. 2021.374
  • Hu X, Deng H, Wang Y, Chen L, Gu X, Wang X. Predictive value of the prognostic nutritional index for the severity of coronavirus disease 2019. Nutrition. 2021;84:111123. doi:10.1016/j.nut.2020.111123
  • Hung KC, Ko CC, Wang LK, et al. Association of prognostic nutritional index with severity and mortality of hospitalized patients with COVID-19: a systematic review and meta-analysis. Diagnostics (Basel). 2022;12(7):1515. doi:10.3390/diagnostics12071515
  • Wang ZH, Lin YW, Wei XB, et al. Predictive value of prognostic nutritional index on COVID-19 severity. Front Nutr. 2021;7:582736. doi:10.3389/fnut.2020.582736
  • Wang R, He M, Yin W, et al. The Prognostic Nutritional Index is associated with mortality of COVID-19 patients in Wuhan, China. J Clin Lab Anal. 2020;34(10):e23566. doi:10.1002/jcla.23566
  • Yılmaz E, Ak R, Doğanay F. Usefulness of the neutrophil-to-lymphocyte ratio in predicting the severity of COVID-19 patients: a retrospective cohort study. Sao Paulo Med J. 2022;140(1):81-86. doi:10.1590/1516-3180.2021.0298.R1.27052021
  • Ak R, Doğanay F, Yilmaz E. Comparison of C-reactive protein and C-reactive protein-to-albumin ratio in predicting mortality among geriatric coronavirus disease 2019 patients. Rev Assoc Med Bras (1992). 2022;68(1):82-86. doi:10.1590/1806-9282.20210811
  • Aziz M, Fatima R, Lee-Smith W, Assaly R. The association of low serum albumin level with severe COVID-19: a systematic review and meta-analysis. Crit Care. 2020;24(1):255. doi:10.1186/s13054 -020-02995-3
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Details

Primary Language English
Subjects Geriatrics and Gerontology, Health Care Administration
Journal Section Research Articles [en] Araştırma Makaleleri [tr]
Authors

Halil Alışkan This is me 0000-0001-5435-7599

Mazlum Kılıç 0000-0002-7517-203X

Project Number -
Publication Date June 28, 2023
Published in Issue Year 2023

Cite

AMA Alışkan H, Kılıç M. The relationship between prognostic nutritional index and mortality in geriatric COVID-19 patients. J Med Palliat Care / JOMPAC / Jompac. June 2023;4(3):241-245. doi:10.47582/jompac.1288909

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