Association of Preoperative Prognostic Nutritional Index and Postoperative Acute Kidney Injury in Patients with Colorectal Cancer Surgery
The prognostic nutritional index (PNI) has been reported to be associated with postoperative complications and prognosis in cancer surgery. However, few studies have evaluated the association between preoperative PNI and postoperative acute kidney injury (AKI) in colorectal cancer patients. This stu...
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| Veröffentlicht in: | Nutrients 2021-05, Vol.13 (5), p.1604 |
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| description | The prognostic nutritional index (PNI) has been reported to be associated with postoperative complications and prognosis in cancer surgery. However, few studies have evaluated the association between preoperative PNI and postoperative acute kidney injury (AKI) in colorectal cancer patients. This study evaluated association of preoperative PNI and postoperative AKI in patients who underwent colorectal cancer surgery. This study retrospectively analyzed 3543 patients who underwent colorectal cancer surgery between June 2008 and February 2012. The patients were classified into four groups by the quartile of PNI: Q1 (≤43.79), Q2 (43.79–47.79), Q3 (47.79–51.62), and Q4 (≥51.62). Multivariate regression analysis was performed to assess the risk factors for AKI and 1-year mortality. AKI was defined according to Kidney Disease Improving Global Outcomes classification (KDIGO) criteria. Additionally, we assessed surgical outcomes such as hospital stay, ICU admission, and postoperative complications. The incidence of postoperative AKI tended to increase in the Q1 group (13.4%, 9.2%, 9.4%, 8.8%). In the multivariate analysis, high preoperative PNI was significantly associated with low risk of postoperative AKI (adjusted odds ratio [OR]: 0.96, 95% confidence interval [CI]: 0.93–0.99, p = 0.003) and low 1-year mortality (OR: 0.92, 95% CI: 0.86–0.98, p = 0.011). Male sex, body mass index, diabetes mellitus, and hypertension were risk factors for AKI. The Q1 (≤43.79) group had poor surgical outcomes, such as postoperative AKI (OR: 1.52, 95% CI: 1.18–1.95, p = 0.001), higher rates of ICU admission (OR: 3.13, 95% CI: 1.82–5.39, p < 0.001) and higher overall mortality (OR: 3.81, 95% CI: 1.86–7.79, p < 0.001). In conclusion, low preoperative PNI levels, especially in the Q1 (≤43.79), were significantly associated with postoperative AKI and surgical outcomes, such as hospital stay, postoperative ICU admission, and mortality. |
| doi_str_mv | 10.3390/nu13051604 |
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However, few studies have evaluated the association between preoperative PNI and postoperative acute kidney injury (AKI) in colorectal cancer patients. This study evaluated association of preoperative PNI and postoperative AKI in patients who underwent colorectal cancer surgery. This study retrospectively analyzed 3543 patients who underwent colorectal cancer surgery between June 2008 and February 2012. The patients were classified into four groups by the quartile of PNI: Q1 (≤43.79), Q2 (43.79–47.79), Q3 (47.79–51.62), and Q4 (≥51.62). Multivariate regression analysis was performed to assess the risk factors for AKI and 1-year mortality. AKI was defined according to Kidney Disease Improving Global Outcomes classification (KDIGO) criteria. Additionally, we assessed surgical outcomes such as hospital stay, ICU admission, and postoperative complications. The incidence of postoperative AKI tended to increase in the Q1 group (13.4%, 9.2%, 9.4%, 8.8%). In the multivariate analysis, high preoperative PNI was significantly associated with low risk of postoperative AKI (adjusted odds ratio [OR]: 0.96, 95% confidence interval [CI]: 0.93–0.99, p = 0.003) and low 1-year mortality (OR: 0.92, 95% CI: 0.86–0.98, p = 0.011). Male sex, body mass index, diabetes mellitus, and hypertension were risk factors for AKI. The Q1 (≤43.79) group had poor surgical outcomes, such as postoperative AKI (OR: 1.52, 95% CI: 1.18–1.95, p = 0.001), higher rates of ICU admission (OR: 3.13, 95% CI: 1.82–5.39, p < 0.001) and higher overall mortality (OR: 3.81, 95% CI: 1.86–7.79, p < 0.001). In conclusion, low preoperative PNI levels, especially in the Q1 (≤43.79), were significantly associated with postoperative AKI and surgical outcomes, such as hospital stay, postoperative ICU admission, and mortality.</description><identifier>ISSN: 2072-6643</identifier><identifier>EISSN: 2072-6643</identifier><identifier>DOI: 10.3390/nu13051604</identifier><identifier>PMID: 34064893</identifier><language>eng</language><publisher>Basel: MDPI AG</publisher><subject>Analysis ; Blood pressure ; Body mass ; Body mass index ; Body size ; Cancer ; Cancer patients ; Cancer surgery ; Care and treatment ; Chronic illnesses ; Classification ; Colorectal cancer ; Colorectal carcinoma ; Complications ; Confidence intervals ; Creatinine ; Diabetes mellitus ; Evaluation ; General anesthesia ; Health aspects ; Hemoglobin ; Hypertension ; Kidney diseases ; Kidneys ; Laboratories ; Laparoscopy ; Length of stay ; Lymphocytes ; Medical prognosis ; Mortality ; Multivariate analysis ; Neutrophils ; Nutrition assessment ; Oncology, Experimental ; Patients ; Prognosis ; Regression analysis ; Risk analysis ; Risk factors ; Statistical analysis ; Surgery ; Variance analysis</subject><ispartof>Nutrients, 2021-05, Vol.13 (5), p.1604</ispartof><rights>COPYRIGHT 2021 MDPI AG</rights><rights>2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 by the authors. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c450t-f81e87cf153085a5825887bacd4872e8a2ba2047faa0a6d0d5b69f0130b3b5283</citedby><cites>FETCH-LOGICAL-c450t-f81e87cf153085a5825887bacd4872e8a2ba2047faa0a6d0d5b69f0130b3b5283</cites><orcidid>0000-0002-6082-2474 ; 0000-0002-6076-6978</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8170895/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8170895/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids></links><search><creatorcontrib>Sim, Ji-Hoon</creatorcontrib><creatorcontrib>Bang, Ji-Yeon</creatorcontrib><creatorcontrib>Kim, Sung-Hoon</creatorcontrib><creatorcontrib>Kang, Sa-Jin</creatorcontrib><creatorcontrib>Song, Jun-Gol</creatorcontrib><title>Association of Preoperative Prognostic Nutritional Index and Postoperative Acute Kidney Injury in Patients with Colorectal Cancer Surgery</title><title>Nutrients</title><description>The prognostic nutritional index (PNI) has been reported to be associated with postoperative complications and prognosis in cancer surgery. However, few studies have evaluated the association between preoperative PNI and postoperative acute kidney injury (AKI) in colorectal cancer patients. This study evaluated association of preoperative PNI and postoperative AKI in patients who underwent colorectal cancer surgery. This study retrospectively analyzed 3543 patients who underwent colorectal cancer surgery between June 2008 and February 2012. The patients were classified into four groups by the quartile of PNI: Q1 (≤43.79), Q2 (43.79–47.79), Q3 (47.79–51.62), and Q4 (≥51.62). Multivariate regression analysis was performed to assess the risk factors for AKI and 1-year mortality. AKI was defined according to Kidney Disease Improving Global Outcomes classification (KDIGO) criteria. Additionally, we assessed surgical outcomes such as hospital stay, ICU admission, and postoperative complications. The incidence of postoperative AKI tended to increase in the Q1 group (13.4%, 9.2%, 9.4%, 8.8%). In the multivariate analysis, high preoperative PNI was significantly associated with low risk of postoperative AKI (adjusted odds ratio [OR]: 0.96, 95% confidence interval [CI]: 0.93–0.99, p = 0.003) and low 1-year mortality (OR: 0.92, 95% CI: 0.86–0.98, p = 0.011). Male sex, body mass index, diabetes mellitus, and hypertension were risk factors for AKI. The Q1 (≤43.79) group had poor surgical outcomes, such as postoperative AKI (OR: 1.52, 95% CI: 1.18–1.95, p = 0.001), higher rates of ICU admission (OR: 3.13, 95% CI: 1.82–5.39, p < 0.001) and higher overall mortality (OR: 3.81, 95% CI: 1.86–7.79, p < 0.001). In conclusion, low preoperative PNI levels, especially in the Q1 (≤43.79), were significantly associated with postoperative AKI and surgical outcomes, such as hospital stay, postoperative ICU admission, and mortality.</description><subject>Analysis</subject><subject>Blood pressure</subject><subject>Body mass</subject><subject>Body mass index</subject><subject>Body size</subject><subject>Cancer</subject><subject>Cancer patients</subject><subject>Cancer surgery</subject><subject>Care and treatment</subject><subject>Chronic illnesses</subject><subject>Classification</subject><subject>Colorectal cancer</subject><subject>Colorectal carcinoma</subject><subject>Complications</subject><subject>Confidence intervals</subject><subject>Creatinine</subject><subject>Diabetes mellitus</subject><subject>Evaluation</subject><subject>General anesthesia</subject><subject>Health aspects</subject><subject>Hemoglobin</subject><subject>Hypertension</subject><subject>Kidney diseases</subject><subject>Kidneys</subject><subject>Laboratories</subject><subject>Laparoscopy</subject><subject>Length of stay</subject><subject>Lymphocytes</subject><subject>Medical prognosis</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Neutrophils</subject><subject>Nutrition assessment</subject><subject>Oncology, Experimental</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Regression analysis</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Variance analysis</subject><issn>2072-6643</issn><issn>2072-6643</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNptks1uEzEQxy1ERau2F57AEheElOL1916QoqhARUUjAWfL6x2njjZ2sHcLeQTeGqetCEXYB894fvP3eDQIvWzIBWMteRunhhHRSMKfoRNKFJ1Jydnzv-xjdF7KmuyXIkqyF-iYcSK5btkJ-jUvJblgx5AiTh4vM6Qt5OrfQXXSKqYyBoc_T2MOe8gO-Cr28BPb2ONlDR7wuZtGwJ9CH2FXofWUdzhEvKxRiGPBP8J4ixdpSBncWHUWNjrI-MuUV5B3Z-jI26HA-eN5ir69v_y6-Di7vvlwtZhfzxwXZJx53YBWzjeCES2s0FRorTrreq4VBW1pZynhyltLrOxJLzrZelKb1LFOUM1O0bsH3e3UbaB3tbRsB7PNYWPzziQbzNNIDLdmle6MbhTRragCrx8Fcvo-QRnNJhQHw2AjpKkYKpjkbUs1r-irf9B1mnLt4T1Fm1o8pwdqZQcwIfpU33V7UTNXUmgptSaVuvgPVXcPm-BSBB_q_ZOENw8JLqdSMvg_f2yI2c-OOcwO-w3nO7Yk</recordid><startdate>20210501</startdate><enddate>20210501</enddate><creator>Sim, Ji-Hoon</creator><creator>Bang, Ji-Yeon</creator><creator>Kim, Sung-Hoon</creator><creator>Kang, Sa-Jin</creator><creator>Song, Jun-Gol</creator><general>MDPI AG</general><general>MDPI</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-6082-2474</orcidid><orcidid>https://orcid.org/0000-0002-6076-6978</orcidid></search><sort><creationdate>20210501</creationdate><title>Association of Preoperative Prognostic Nutritional Index and Postoperative Acute Kidney Injury in Patients with Colorectal Cancer Surgery</title><author>Sim, Ji-Hoon ; 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However, few studies have evaluated the association between preoperative PNI and postoperative acute kidney injury (AKI) in colorectal cancer patients. This study evaluated association of preoperative PNI and postoperative AKI in patients who underwent colorectal cancer surgery. This study retrospectively analyzed 3543 patients who underwent colorectal cancer surgery between June 2008 and February 2012. The patients were classified into four groups by the quartile of PNI: Q1 (≤43.79), Q2 (43.79–47.79), Q3 (47.79–51.62), and Q4 (≥51.62). Multivariate regression analysis was performed to assess the risk factors for AKI and 1-year mortality. AKI was defined according to Kidney Disease Improving Global Outcomes classification (KDIGO) criteria. Additionally, we assessed surgical outcomes such as hospital stay, ICU admission, and postoperative complications. The incidence of postoperative AKI tended to increase in the Q1 group (13.4%, 9.2%, 9.4%, 8.8%). In the multivariate analysis, high preoperative PNI was significantly associated with low risk of postoperative AKI (adjusted odds ratio [OR]: 0.96, 95% confidence interval [CI]: 0.93–0.99, p = 0.003) and low 1-year mortality (OR: 0.92, 95% CI: 0.86–0.98, p = 0.011). Male sex, body mass index, diabetes mellitus, and hypertension were risk factors for AKI. The Q1 (≤43.79) group had poor surgical outcomes, such as postoperative AKI (OR: 1.52, 95% CI: 1.18–1.95, p = 0.001), higher rates of ICU admission (OR: 3.13, 95% CI: 1.82–5.39, p < 0.001) and higher overall mortality (OR: 3.81, 95% CI: 1.86–7.79, p < 0.001). In conclusion, low preoperative PNI levels, especially in the Q1 (≤43.79), were significantly associated with postoperative AKI and surgical outcomes, such as hospital stay, postoperative ICU admission, and mortality.</abstract><cop>Basel</cop><pub>MDPI AG</pub><pmid>34064893</pmid><doi>10.3390/nu13051604</doi><orcidid>https://orcid.org/0000-0002-6082-2474</orcidid><orcidid>https://orcid.org/0000-0002-6076-6978</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Analysis Blood pressure Body mass Body mass index Body size Cancer Cancer patients Cancer surgery Care and treatment Chronic illnesses Classification Colorectal cancer Colorectal carcinoma Complications Confidence intervals Creatinine Diabetes mellitus Evaluation General anesthesia Health aspects Hemoglobin Hypertension Kidney diseases Kidneys Laboratories Laparoscopy Length of stay Lymphocytes Medical prognosis Mortality Multivariate analysis Neutrophils Nutrition assessment Oncology, Experimental Patients Prognosis Regression analysis Risk analysis Risk factors Statistical analysis Surgery Variance analysis |
| title | Association of Preoperative Prognostic Nutritional Index and Postoperative Acute Kidney Injury in Patients with Colorectal Cancer Surgery |
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