Xiang Weiwei, Chen Xiyi, Ye Weiyi, Li Jia, Zhang Xu, Xie Dewei
Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Department of Cardiovascular and Thoracic Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Front Neurol. 2020 Jun 26;11:599. doi: 10.3389/fneur.2020.00599. eCollection 2020.
Malnutrition has been reported to be related to adverse prognosis in acute ischemic stroke (AIS) patients. Unfortunately, traditional nutritional assessment tools usually increase the workload of neurologists, which makes them unfeasible in the daily clinic work. We aimed to elucidate the association between the prognostic nutritional index (PNI), an easily obtainable baseline nutritional marker, and 3-month outcomes in AIS patients receiving intravenous thrombolysis (IVT). The present study retrospectively included 405 patients. PNI was calculated as 5lymphocyte count (10 /L) + serum albumin concentration (g/L), and the good prognosis was defined as modified Rankin Scale score of 0-3. The relationship between PNI and clinical parameters was evaluated. The multiple logistic regression model was performed to find out independent predictors of the 3-month outcomes. We found that the patients in the low PNI group had a higher frequency of anemia (12.9 vs. 2.3%, < 0.001) and a higher level of the Controlling nutritional status (CONUT) score ( < 0.001). The relationship between PNI and nutrition-related factors, such as body mass index ( = 0.208, = 0.001), age ( = -0.329, < 0.001), total cholesterol ( = 0.268, < 0.001) and hemoglobin concentration ( = 0.328, < 0.001), was significant. Low PNI value (adjusted odds ratio: 2.250, confidence interval: 1.192-4.249, = 0.012) stayed as an independent predictor for the poor outcome at three months, after adjustment for potential confounders. The PNI was independently associated with 3-month outcomes in AIS patients undergoing IVT. As an easily obtainable nutritional marker, PNI may be a useful nutritional assessment tool in the clinic work.
据报道，营养不良与急性缺血性脑卒中（AIS）患者的不良预后相关。不幸的是，传统的营养评估工具通常会增加神经科医生的工作量，这使得它们在日常临床工作中不可行。我们旨在阐明预后营养指数（PNI）（一种易于获得的基线营养标志物）与接受静脉溶栓（IVT）的AIS患者3个月预后之间的关联。本研究回顾性纳入了405例患者。PNI的计算方法为5×淋巴细胞计数（×10⁹/L）+血清白蛋白浓度（g/L），良好预后定义为改良Rankin量表评分为0 - 3分。评估了PNI与临床参数之间的关系。采用多因素logistic回归模型找出3个月预后的独立预测因素。我们发现，低PNI组患者贫血发生率更高（12.9% vs. 2.3%，P < 0.001），且控制营养状况（CONUT）评分更高（P < 0.001）。PNI与营养相关因素之间存在显著关系，如体重指数（r = 0.208，P = 0.001）、年龄（r = -0.329，P < 0.001）、总胆固醇（r = 0.268，P < 0.001）和血红蛋白浓度（r = 0.328，P < 0.001）。在调整潜在混杂因素后，低PNI值（调整后的比值比：2.250，置信区间：1.192 - 4.249，P = 0.012）仍然是3个月不良预后的独立预测因素。PNI与接受IVT的AIS患者3个月预后独立相关。作为一种易于获得的营养标志物，PNI可能是临床工作中一种有用的营养评估工具。
