The prognostic value of prognostic nutritional index and renal function indicators for mortality prediction in severe COVID-19 elderly patients: A retrospective study
Identifying prognostic factors in elderly patients with severe coronavirus disease 2019 (COVID-19) is crucial for clinical management. Recent evidence suggests malnutrition and renal dysfunction are associated with poor outcome. This study aimed to develop a prognostic model incorporating prognostic...
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| Veröffentlicht in: | Medicine (Baltimore) 2024-05, Vol.103 (20), p.e38213 |
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| creator | Cao, Angyang Luo, Wenjun Wang, Long Wang, Jianhua Zhou, Yanling Huang, Changshun Zhu, Binbin |
| description | Identifying prognostic factors in elderly patients with severe coronavirus disease 2019 (COVID-19) is crucial for clinical management. Recent evidence suggests malnutrition and renal dysfunction are associated with poor outcome. This study aimed to develop a prognostic model incorporating prognostic nutritional index (PNI), estimated glomerular filtration rate (eGFR), and other parameters to predict mortality risk. This retrospective analysis included 155 elderly patients with severe COVID-19. Clinical data and outcomes were collected. Logistic regression analyzed independent mortality predictors. A joint predictor "L" incorporating PNI, eGFR, D-dimer, and lactate dehydrogenase (LDH) was developed and internally validated using bootstrapping. Decreased PNI (OR = 1.103, 95% CI: 0.78-1.169), decreased eGFR (OR = 0.964, 95% CI: 0.937-0.992), elevated D-dimer (OR = 1.001, 95% CI: 1.000-1.004), and LDH (OR = 1.005, 95% CI: 1.001-1.008) were independent mortality risk factors (all P |
| doi_str_mv | 10.1097/MD.0000000000038213 |
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Recent evidence suggests malnutrition and renal dysfunction are associated with poor outcome. This study aimed to develop a prognostic model incorporating prognostic nutritional index (PNI), estimated glomerular filtration rate (eGFR), and other parameters to predict mortality risk. This retrospective analysis included 155 elderly patients with severe COVID-19. Clinical data and outcomes were collected. Logistic regression analyzed independent mortality predictors. A joint predictor "L" incorporating PNI, eGFR, D-dimer, and lactate dehydrogenase (LDH) was developed and internally validated using bootstrapping. Decreased PNI (OR = 1.103, 95% CI: 0.78-1.169), decreased eGFR (OR = 0.964, 95% CI: 0.937-0.992), elevated D-dimer (OR = 1.001, 95% CI: 1.000-1.004), and LDH (OR = 1.005, 95% CI: 1.001-1.008) were independent mortality risk factors (all P < .05). The joint predictor "L" showed good discrimination (area under the curve [AUC] = 0.863) and calibration. The bootstrapped area under the curve was 0.858, confirming model stability. A combination of PNI, eGFR, D-dimer, and LDH provides useful prognostic information to identify elderly patients with severe COVID-19 at highest mortality risk for early intervention. Further external validation is warranted.</description><identifier>ISSN: 0025-7974</identifier><identifier>ISSN: 1536-5964</identifier><identifier>EISSN: 1536-5964</identifier><identifier>DOI: 10.1097/MD.0000000000038213</identifier><identifier>PMID: 38758852</identifier><language>eng</language><publisher>United States: Lippincott Williams & Wilkins</publisher><subject>Aged ; Aged, 80 and over ; COVID-19 - complications ; COVID-19 - mortality ; Female ; Fibrin Fibrinogen Degradation Products - analysis ; Fibrin Fibrinogen Degradation Products - metabolism ; Glomerular Filtration Rate ; Humans ; L-Lactate Dehydrogenase - blood ; Male ; Malnutrition - diagnosis ; Malnutrition - mortality ; Nutrition Assessment ; Observational Study ; Prognosis ; Retrospective Studies ; Risk Factors ; SARS-CoV-2 ; Severity of Illness Index</subject><ispartof>Medicine (Baltimore), 2024-05, Vol.103 (20), p.e38213</ispartof><rights>Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.</rights><rights>Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc. 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c356t-9c8d7b3a5519a43355f62a83fdf38cf6376c58e2c37da3f9deb8da1c174b8ac63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11098216/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11098216/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27903,27904,53769,53771</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38758852$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cao, Angyang</creatorcontrib><creatorcontrib>Luo, Wenjun</creatorcontrib><creatorcontrib>Wang, Long</creatorcontrib><creatorcontrib>Wang, Jianhua</creatorcontrib><creatorcontrib>Zhou, Yanling</creatorcontrib><creatorcontrib>Huang, Changshun</creatorcontrib><creatorcontrib>Zhu, Binbin</creatorcontrib><title>The prognostic value of prognostic nutritional index and renal function indicators for mortality prediction in severe COVID-19 elderly patients: A retrospective study</title><title>Medicine (Baltimore)</title><addtitle>Medicine (Baltimore)</addtitle><description>Identifying prognostic factors in elderly patients with severe coronavirus disease 2019 (COVID-19) is crucial for clinical management. Recent evidence suggests malnutrition and renal dysfunction are associated with poor outcome. This study aimed to develop a prognostic model incorporating prognostic nutritional index (PNI), estimated glomerular filtration rate (eGFR), and other parameters to predict mortality risk. This retrospective analysis included 155 elderly patients with severe COVID-19. Clinical data and outcomes were collected. Logistic regression analyzed independent mortality predictors. A joint predictor "L" incorporating PNI, eGFR, D-dimer, and lactate dehydrogenase (LDH) was developed and internally validated using bootstrapping. Decreased PNI (OR = 1.103, 95% CI: 0.78-1.169), decreased eGFR (OR = 0.964, 95% CI: 0.937-0.992), elevated D-dimer (OR = 1.001, 95% CI: 1.000-1.004), and LDH (OR = 1.005, 95% CI: 1.001-1.008) were independent mortality risk factors (all P < .05). The joint predictor "L" showed good discrimination (area under the curve [AUC] = 0.863) and calibration. The bootstrapped area under the curve was 0.858, confirming model stability. A combination of PNI, eGFR, D-dimer, and LDH provides useful prognostic information to identify elderly patients with severe COVID-19 at highest mortality risk for early intervention. Further external validation is warranted.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>COVID-19 - complications</subject><subject>COVID-19 - mortality</subject><subject>Female</subject><subject>Fibrin Fibrinogen Degradation Products - analysis</subject><subject>Fibrin Fibrinogen Degradation Products - metabolism</subject><subject>Glomerular Filtration Rate</subject><subject>Humans</subject><subject>L-Lactate Dehydrogenase - blood</subject><subject>Male</subject><subject>Malnutrition - diagnosis</subject><subject>Malnutrition - mortality</subject><subject>Nutrition Assessment</subject><subject>Observational Study</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>SARS-CoV-2</subject><subject>Severity of Illness Index</subject><issn>0025-7974</issn><issn>1536-5964</issn><issn>1536-5964</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkV1vFCEYhYnR2LX6C0wMl95MC8PwMd6YZtePJm1603pLWHhpMbPDCszG_UP-Tpl0bWu5IXDOeXjJQeg9JSeU9PL0cnVCHhdTLWUv0IJyJhrei-4lWhDS8kb2sjtCb3L-SQhlsu1eoyOmJFeKtwv05_oO8DbF2zHmEizemWECHP3Tu3EqKZQQRzPgMDr4jc3ocIL57KfRztIsBGtKTBn7mPAmpmKGUPYVBFU5eHCGHSTAy6sf56uG9hgGB2moLlMCjCV_wmeVXFLMW6ihHeBcJrd_i155M2R4d9iP0c3XL9fL783F1bfz5dlFYxkXpemtcnLNDOe0Nx1jnHvRGsW880xZL5gUlitoLZPOMN87WCtnqKWyWytjBTtGn--522m9AWfrSMkMepvCxqS9jibo_5Ux3OnbuNO0VlIbmAkfD4QUf02Qi96EbGEYzAhxypoRLoRoSSurld1bbf1uTuAf3qFEzxXry5V-XnFNfXg64kPmX6fsL4fJp0c</recordid><startdate>20240517</startdate><enddate>20240517</enddate><creator>Cao, Angyang</creator><creator>Luo, Wenjun</creator><creator>Wang, Long</creator><creator>Wang, Jianhua</creator><creator>Zhou, Yanling</creator><creator>Huang, Changshun</creator><creator>Zhu, Binbin</creator><general>Lippincott Williams & Wilkins</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20240517</creationdate><title>The prognostic value of prognostic nutritional index and renal function indicators for mortality prediction in severe COVID-19 elderly patients: A retrospective study</title><author>Cao, Angyang ; Luo, Wenjun ; Wang, Long ; Wang, Jianhua ; Zhou, Yanling ; Huang, Changshun ; Zhu, Binbin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-9c8d7b3a5519a43355f62a83fdf38cf6376c58e2c37da3f9deb8da1c174b8ac63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>COVID-19 - complications</topic><topic>COVID-19 - mortality</topic><topic>Female</topic><topic>Fibrin Fibrinogen Degradation Products - analysis</topic><topic>Fibrin Fibrinogen Degradation Products - metabolism</topic><topic>Glomerular Filtration Rate</topic><topic>Humans</topic><topic>L-Lactate Dehydrogenase - blood</topic><topic>Male</topic><topic>Malnutrition - diagnosis</topic><topic>Malnutrition - mortality</topic><topic>Nutrition Assessment</topic><topic>Observational Study</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>SARS-CoV-2</topic><topic>Severity of Illness Index</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cao, Angyang</creatorcontrib><creatorcontrib>Luo, Wenjun</creatorcontrib><creatorcontrib>Wang, Long</creatorcontrib><creatorcontrib>Wang, Jianhua</creatorcontrib><creatorcontrib>Zhou, Yanling</creatorcontrib><creatorcontrib>Huang, Changshun</creatorcontrib><creatorcontrib>Zhu, Binbin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Medicine (Baltimore)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cao, Angyang</au><au>Luo, Wenjun</au><au>Wang, Long</au><au>Wang, Jianhua</au><au>Zhou, Yanling</au><au>Huang, Changshun</au><au>Zhu, Binbin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The prognostic value of prognostic nutritional index and renal function indicators for mortality prediction in severe COVID-19 elderly patients: A retrospective study</atitle><jtitle>Medicine (Baltimore)</jtitle><addtitle>Medicine (Baltimore)</addtitle><date>2024-05-17</date><risdate>2024</risdate><volume>103</volume><issue>20</issue><spage>e38213</spage><pages>e38213-</pages><issn>0025-7974</issn><issn>1536-5964</issn><eissn>1536-5964</eissn><abstract>Identifying prognostic factors in elderly patients with severe coronavirus disease 2019 (COVID-19) is crucial for clinical management. Recent evidence suggests malnutrition and renal dysfunction are associated with poor outcome. This study aimed to develop a prognostic model incorporating prognostic nutritional index (PNI), estimated glomerular filtration rate (eGFR), and other parameters to predict mortality risk. This retrospective analysis included 155 elderly patients with severe COVID-19. Clinical data and outcomes were collected. Logistic regression analyzed independent mortality predictors. A joint predictor "L" incorporating PNI, eGFR, D-dimer, and lactate dehydrogenase (LDH) was developed and internally validated using bootstrapping. Decreased PNI (OR = 1.103, 95% CI: 0.78-1.169), decreased eGFR (OR = 0.964, 95% CI: 0.937-0.992), elevated D-dimer (OR = 1.001, 95% CI: 1.000-1.004), and LDH (OR = 1.005, 95% CI: 1.001-1.008) were independent mortality risk factors (all P < .05). The joint predictor "L" showed good discrimination (area under the curve [AUC] = 0.863) and calibration. The bootstrapped area under the curve was 0.858, confirming model stability. A combination of PNI, eGFR, D-dimer, and LDH provides useful prognostic information to identify elderly patients with severe COVID-19 at highest mortality risk for early intervention. Further external validation is warranted.</abstract><cop>United States</cop><pub>Lippincott Williams & Wilkins</pub><pmid>38758852</pmid><doi>10.1097/MD.0000000000038213</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over COVID-19 - complications COVID-19 - mortality Female Fibrin Fibrinogen Degradation Products - analysis Fibrin Fibrinogen Degradation Products - metabolism Glomerular Filtration Rate Humans L-Lactate Dehydrogenase - blood Male Malnutrition - diagnosis Malnutrition - mortality Nutrition Assessment Observational Study Prognosis Retrospective Studies Risk Factors SARS-CoV-2 Severity of Illness Index |
| title | The prognostic value of prognostic nutritional index and renal function indicators for mortality prediction in severe COVID-19 elderly patients: A retrospective study |
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