Factors influencing nutritional assessment in abdominal trauma patients

Previous work has shown that an abdominal trauma index (ATI) based on anatomic severity of injury reliably predicts complications following abdominal trauma, whereas the Prognostic Nutritional Index (PNI) does not. This study was undertaken to reconcile the disparity between the PNI and ATI as predictors of postoperative morbidity and mortality. Twenty-four patients undergoing immediate laparotomy following acute abdominal trauma were evaluated. Their mean age was 32.8 years (range 18-59 years); 18 were men. All patients underwent nutritional assessment within 12 hours of surgery. A statistical comparison of blood replacement, operating time, ATI, and PNI was performed. The mean PNI was 51 and mean blood replacement was 12.5 units. Using linear regression the PNI and amount of blood replacement correlated significantly (r = 0..44, p less than 0.05). Operating time and ATI did not correlate with PNI. In conclusion, the PNI was more strongly influenced by blood loss than severity of intraperitoneal injury. For this reason it is relatively ineffective in predicting complications following trauma.