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Usefulness of Preoperative Prognostic Nutritional Index in Secondary Spontaneous Pneumothorax
Toshio Shiotani1, Kaoru Kondo1, Shinichi Furukawa1
1Department of Thoracic Surgery, NHO Iwakuni Clinical Center, Yamaguchi, Japan.
Background:
The prognostic nutritional index has been identified as a predictor of postoperative outcomes in various fields. We investigated the usefulness of the prognostic nutritional index as a risk factor for postoperative complications in secondary spontaneous pneumothorax.
Methods:
In this retrospective study, patients who underwent surgery for secondary spontaneous pneumothorax were reviewed. The associations among the prognostic nutritional index, body mass index, and performance status were examined, and risk factors for postoperative complications were investigated in a multivariate analysis. In the subgroup analysis, on the basis of the receiver operating characteristics, we divided patients into high- and low-prognostic nutritional index groups and investigated the utility of the prognostic nutritional index for postoperative complications.
Results:
Of 91 patients who underwent surgery for secondary spontaneous pneumothorax, 34 patients with postoperative complications were included. The prognostic nutritional index was significantly positively and negatively correlated with body mass index (P < .001) and performance status (P < .001), respectively. Multivariate analysis revealed that a decreased prognostic nutritional index was an independent risk factor for postoperative complications (P = .0048). In the subgroup analysis, the postoperative outcomes, including the duration of chest tube placement (P = .042), hospital stay (P = .0014), complications (P = .0089), and mortality (P = .044), were significantly worse in the low- than in the high-prognostic nutritional index group.
Conclusions:
The prognostic nutritional index may be useful for evaluating the severity of secondary spontaneous pneumothorax in preoperative patients and may be a risk for postoperative complications.
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