Prognostic nutritional index predicts mortality in infective endocarditis [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2020; 48(4): 392-402 | DOI: 10.5543/tkda.2020.25899

Prognostic nutritional index predicts mortality in infective endocarditis

Serkan Kahraman1, Hicaz Zencirkıran Aguş1, Ali Kemal Kalkan1, Fatih Uzun1, Mehmet Ertürk1, Mehmet Emin Kalkan2, Mustafa Yıldız1
1Department of Cardiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
2Department of Cardiology, Kartal Koşuyolu High Speciality Training and Research Hospital, İstanbul, Turkey


OBJECTIVE
The prognostic nutritional index (PNI), based on serum albumin and lymphocyte concentration, is an inflammation-based nutritional score that has been shown to be a prognostic determinant in several populations. The aim of this study was to investigate the impact of PNI on mortality in patients with infective endocarditis (IE).

METHODS
A total of 131 patients with IE were enrolled in this retrospective study. The patients were divided into 2 groups based on in-hospital mortality. The PNI value of the patients was evaluated, as well as baseline clinical and demographical variables.

RESULTS
Among the study group, 29 patients died in-hospital during the median follow-up of 37 days. The PNI was found to be lower in cases of mortality (35.90±6.96; 31.09±5.88; p=0.001). ROC curve analysis also demonstrated that the PNI had a good predictive value for in-hospital mortality with a cut-off value of 35.6 (Area under the curve: 0.691; 95% confidence interval [CI]: 0.589–0.794; p=0.002). In multivariate logistic regression analysis, advanced age (Odds ratio [OR]: 1.078; 95% CI: 1.017–1.143; p=0.012), PNI (OR: 0.911; 95% CI: 0.835–0.993; p=0.034), and leaflet perforation (OR: 5.557; 95% CI: 1.357–22.765; p=0.017) were found to be independent predictors of mortality. Kaplan-Meier survival analysis revealed that long-term survival was found to be significantly decreased in patients with a lower PNI (Log rank: p=0.008).

CONCLUSION
The PNI result was associated with an increased in-hospital mortality rate in patients with IE. The PNI value, advanced age, and cardiac valve perforation as a complication of IE were found to be independent predictors of mortality.

Keywords: Albumin, infective endocarditis; in-hospital mortality; lymphocyte; prognosis; prognostic nutritional index.

How to cite this article
Serkan Kahraman, Hicaz Zencirkıran Aguş, Ali Kemal Kalkan, Fatih Uzun, Mehmet Ertürk, Mehmet Emin Kalkan, Mustafa Yıldız. Prognostic nutritional index predicts mortality in infective endocarditis. Turk Kardiyol Dern Ars. 2020; 48(4): 392-402

Corresponding Author: Serkan Kahraman, Türkiye
© Copyright 2020 Archives of the Turkish Society of Cardiology
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