Preoperative nutritional scores to predict mortality after liver transplantation: a retrospective cohort study
Background Malnutrition is a well-known risk factor for mortality and morbidity. We investigated whether preoperative malnutrition, diagnosed using an objective nutritional index, was associated with postoperative mortality in patients undergoing liver transplantation (LT). Methods This retrospectiv...
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Korean Society of Anesthesiologists
2024-10-01
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| Series: | Anesthesia and Pain Medicine |
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| Online Access: | http://anesth-pain-med.org/upload/pdf/apm-24045.pdf |
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| author | Eun Jung Kim Jin Ha Park Soo Yeon Kim Jin Sun Cho |
| author_facet | Eun Jung Kim Jin Ha Park Soo Yeon Kim Jin Sun Cho |
| author_sort | Eun Jung Kim |
| collection | DOAJ |
| description | Background Malnutrition is a well-known risk factor for mortality and morbidity. We investigated whether preoperative malnutrition, diagnosed using an objective nutritional index, was associated with postoperative mortality in patients undergoing liver transplantation (LT). Methods This retrospective cohort observational study assessed the preoperative nutritional status of 440 patients who underwent LT, using the Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) score. We evaluated the association between preoperative malnutrition and 3-year postoperative mortality using the Kaplan–Meier curve and log-rank test. In addition, we identified prognostic factors for mortality using Cox proportional hazard analysis. Results Malnutrition was identified in 72.7% (n = 320), 66.1% (n = 291), and 97.3% (n = 428) of patients as assessed by the NRI, PNI, and CONUT score, respectively. The Kaplan–Meier survival curve demonstrated that mortality increased with the presence and severity of malnutrition risk, as assessed by the NRI and PNI, respectively; however, NRI was the only index identified as an independent risk factor for mortality, along with preoperative renal replacement therapy, platelet count, and C-reactive protein. After adjustment, lower NRI was associated with a higher risk of mortality (hazard ratio 0.97, 95% confidence interval 0.95–0.99, P = 0.009). The malnutrition group (NRI ≤ 100) had a significantly greater incidence of postoperative acute kidney injury than that of the normal group. Conclusions Preoperative NRI is an independent risk factor for mortality after LT, and therefore it would be a helpful tool for mortality risk stratification in patients undergoing LT. |
| format | Article |
| id | doaj-art-8208b3b621fe4d2cbbf4b48a7ec8db4c |
| institution | Kabale University |
| issn | 1975-5171 2383-7977 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Korean Society of Anesthesiologists |
| record_format | Article |
| series | Anesthesia and Pain Medicine |
| spelling | doaj-art-8208b3b621fe4d2cbbf4b48a7ec8db4c2024-11-18T07:05:31ZengKorean Society of AnesthesiologistsAnesthesia and Pain Medicine1975-51712383-79772024-10-0119433934810.17085/apm.240451275Preoperative nutritional scores to predict mortality after liver transplantation: a retrospective cohort studyEun Jung Kim0Jin Ha Park1Soo Yeon Kim2Jin Sun Cho3 Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, KoreaBackground Malnutrition is a well-known risk factor for mortality and morbidity. We investigated whether preoperative malnutrition, diagnosed using an objective nutritional index, was associated with postoperative mortality in patients undergoing liver transplantation (LT). Methods This retrospective cohort observational study assessed the preoperative nutritional status of 440 patients who underwent LT, using the Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) score. We evaluated the association between preoperative malnutrition and 3-year postoperative mortality using the Kaplan–Meier curve and log-rank test. In addition, we identified prognostic factors for mortality using Cox proportional hazard analysis. Results Malnutrition was identified in 72.7% (n = 320), 66.1% (n = 291), and 97.3% (n = 428) of patients as assessed by the NRI, PNI, and CONUT score, respectively. The Kaplan–Meier survival curve demonstrated that mortality increased with the presence and severity of malnutrition risk, as assessed by the NRI and PNI, respectively; however, NRI was the only index identified as an independent risk factor for mortality, along with preoperative renal replacement therapy, platelet count, and C-reactive protein. After adjustment, lower NRI was associated with a higher risk of mortality (hazard ratio 0.97, 95% confidence interval 0.95–0.99, P = 0.009). The malnutrition group (NRI ≤ 100) had a significantly greater incidence of postoperative acute kidney injury than that of the normal group. Conclusions Preoperative NRI is an independent risk factor for mortality after LT, and therefore it would be a helpful tool for mortality risk stratification in patients undergoing LT.http://anesth-pain-med.org/upload/pdf/apm-24045.pdfcontrolling nutritional status scoreliver transplantationmalnutritionnutritional risk indexobjective nutritional indexprognostic nutritional index |
| spellingShingle | Eun Jung Kim Jin Ha Park Soo Yeon Kim Jin Sun Cho Preoperative nutritional scores to predict mortality after liver transplantation: a retrospective cohort study Anesthesia and Pain Medicine controlling nutritional status score liver transplantation malnutrition nutritional risk index objective nutritional index prognostic nutritional index |
| title | Preoperative nutritional scores to predict mortality after liver transplantation: a retrospective cohort study |
| title_full | Preoperative nutritional scores to predict mortality after liver transplantation: a retrospective cohort study |
| title_fullStr | Preoperative nutritional scores to predict mortality after liver transplantation: a retrospective cohort study |
| title_full_unstemmed | Preoperative nutritional scores to predict mortality after liver transplantation: a retrospective cohort study |
| title_short | Preoperative nutritional scores to predict mortality after liver transplantation: a retrospective cohort study |
| title_sort | preoperative nutritional scores to predict mortality after liver transplantation a retrospective cohort study |
| topic | controlling nutritional status score liver transplantation malnutrition nutritional risk index objective nutritional index prognostic nutritional index |
| url | http://anesth-pain-med.org/upload/pdf/apm-24045.pdf |
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