Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea.
Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea.
Nutrients. 2020 Feb 21;12(2):562. doi: 10.3390/nu12020562.
The nutritional condition of patients is an important prognostic factor in various diseases. Free flap failure is a serious complication in patients undergoing free flap reconstruction, increasing morbidity and hospital costs. We evaluated the predictive factors, including the prognostic nutritional index (PNI), associated with free flap failure in extremity reconstruction. The PNI was calculated as follows: 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (per mm), with a PNI <40 defined as low. Univariate and multivariate logistic regression analyses were performed to evaluate factors predictive of free flap failure. Postoperative outcomes, including duration of hospital stay and rate and duration of intensive care unit admission, were also evaluated. Of the 625 patients included, 38 (6.1%) experienced free flap failure. Multivariate logistic regression analysis revealed that predictors of free flap failure were female (odds ratio: 2.094; = 0.031) and a low PNI (odds ratio: 3.859; <0.001). The duration of hospital stay was significantly longer in patients who did than those who did not experience free flap failure (62.1 ± 55.5 days vs. 28.3 ± 24.4 days, <0.001). A low PNI is associated with free flap failure, leading to prolonged hospital stay. This result suggests that the PNI can be simply and effectively used to predict free flap failure.
患者的营养状况是各种疾病中重要的预后因素。游离皮瓣失败是游离皮瓣重建患者的一种严重并发症，增加了发病率和住院费用。我们评估了与四肢重建游离皮瓣失败相关的预测因素，包括预后营养指数（PNI）。PNI 的计算方法如下：血清白蛋白（g/dL）×10+总淋巴细胞计数（每毫米）×0.005，PNI<40 定义为低。进行了单因素和多因素逻辑回归分析，以评估与游离皮瓣失败相关的因素。还评估了术后结果，包括住院时间、入住重症监护病房的比例和时间。在纳入的 625 例患者中，38 例（6.1%）发生游离皮瓣失败。多因素逻辑回归分析显示，游离皮瓣失败的预测因素是女性（比值比：2.094； = 0.031）和低 PNI（比值比：3.859； <0.001）。发生游离皮瓣失败的患者的住院时间明显长于未发生游离皮瓣失败的患者（62.1±55.5 天 vs. 28.3±24.4 天， <0.001）。低 PNI 与游离皮瓣失败相关，导致住院时间延长。该结果表明，PNI 可简单有效地用于预测游离皮瓣失败。
