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那不勒斯预后评分在主动脉瓣置换手术死亡率预测中的应用。

Naples prognostic score as a predictor of mortality in surgical aortic valve replacement.

机构信息

Department of Cardiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic & Cardiovascular Surgery Training & Research Hospital, Istanbul, 34303, Turkiye.

Department of Internal Medicine, Division of Geriatrics, Tekirdağ Ismail Fehmi Cumalıoğlu City Hospital, Tekirdağ, 59030,Turkiye.

出版信息

Biomark Med. 2024 Aug 17;18(15-16):675-683. doi: 10.1080/17520363.2024.2389035. Epub 2024 Sep 12.

Abstract

Investigating the impact of nutritional and inflammatory status, assessed by the Naples-Prognostic-Score (NPS), on postoperative mortality in 173 older adults undergoing surgical aortic valve replacement(SAVR) for aortic stenosis(AS). Retrospective study calculating NPS from neutrophils/lymphocytes, lymphocytes/monocytes, total cholesterol and serum albumin. Mean age was 69.39 ± 6.153 with 45.1% females. The post-operative mortality was 23.7% over a follow-up period of 50 ± 31 months. The 1-month mortality rate is 2.89%. High NPS significantly associated with increased mortality; multivariate logistic regression confirmed its independence (odds-ratio:3.494, 95% confidence-interval:1.555-7.849,  = 0.002). NPS cutoff of 2 showed 73.2% sensitivity, 56.8% specificity and area-under-the-curve of 0.758 for predicting all-cause mortality. Kaplan-Meier analysis supported lower NPS correlating with better survival. NPS independently predicts postoperative mortality in SAVR patients.

摘要

探讨营养和炎症状态(通过那不勒斯预后评分[NPS]评估)对 173 名接受手术主动脉瓣置换术(SAVR)治疗主动脉瓣狭窄(AS)的老年患者术后死亡率的影响。回顾性研究通过中性粒细胞/淋巴细胞、淋巴细胞/单核细胞、总胆固醇和血清白蛋白计算 NPS。平均年龄为 69.39±6.153 岁,女性占 45.1%。术后 50±31 个月的随访期间死亡率为 23.7%。1 个月的死亡率为 2.89%。高 NPS 与死亡率增加显著相关;多变量逻辑回归证实了其独立性(优势比:3.494,95%置信区间:1.555-7.849,=0.002)。NPS 截断值为 2 时,预测全因死亡率的敏感性为 73.2%,特异性为 56.8%,曲线下面积为 0.758。Kaplan-Meier 分析支持 NPS 越低,生存率越高。NPS 可独立预测 SAVR 患者的术后死亡率。

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