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Related Experiment Videos

Predicting mortality based on body composition analysis.

J M Tellado1, J L Garcia-Sabrido, J A Hanley

  • 1Servicio Cirugia General II, Hospital Gregorio Marañon, Madrid, Spain.

Annals of Surgery
|January 1, 1989
PubMed
Summary

The Nae/Ke ratio, a measure of exchangeable sodium to potassium, effectively identifies surgical patients at risk of mortality. This nutritional marker proved superior to traditional anthropometric and biochemical assessments in predicting patient outcomes.

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Area of Science:

  • Nutritional biochemistry
  • Surgical patient monitoring
  • Biomarker discovery

Background:

  • Malnutrition is a significant risk factor for mortality in surgical patients.
  • Traditional nutritional markers often lack predictive power for mortality.
  • The Nae/Ke ratio's potential as a predictive nutritional marker requires investigation.

Purpose of the Study:

  • To evaluate the Nae/Ke ratio as a nutritional marker for identifying surgical patients at risk of mortality.
  • To compare the predictive power of the Nae/Ke ratio against anthropometric, biochemical, and immunologic markers.
  • To develop and validate a predictive model for hospital mortality based on the Nae/Ke ratio.

Main Methods:

  • Multiple isotope dilution was used to determine the Nae/Ke ratio in 73 malnourished surgical patients (Training Group).

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  • Stepwise discriminant analysis and logistic regression were employed to assess predictive power for hospital mortality.
  • The developed model was validated in a separate cohort of 417 surgical patients (Validation Group).

    • Main Results:

    • The Nae/Ke ratio demonstrated exceptionally strong predictive power for mortality (p < 0.00001), surpassing all other assessed variables.
    • A logistic regression model (Pr/death/ = 1/(1 + e[11.8-5.2 Nae/Ke])) was developed, identifying Nae/Ke ratios of 1.5 and 2.5 as markers for non-risk and mortality.
    • Validation in an independent cohort confirmed the model's accuracy, with observed deaths closely matching expected deaths (X2 = 1.8 NS) and high ROC curve areas (Az ≈ 0.91).

    Conclusions:

    • The Nae/Ke ratio is a superior method for identifying malnourished surgical patients at risk of dying compared to conventional anthropometric and biochemical measurements.
    • The Nae/Ke ratio offers a robust and validated tool for risk stratification in surgical patient populations.
    • Availability of the Nae/Ke ratio can significantly improve clinical decision-making and patient management in surgical settings.