Archives of the Turkish Society of Cardiology
Prognostic nutritional index predicts mortality in infective endocarditis [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. Ahead of Print: TKDA-25899 | DOI: 10.5543/tkda.2020.25899

Prognostic nutritional index predicts mortality in infective endocarditis

Serkan Kahraman1, Hicaz Zencirkiran Agus1, Ali Kemal Kalkan1, Fatih Uzun1, Mehmet Erturk1, Mehmet Emin Kalkan2, Mustafa Yildiz1
1university of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Department of Cardiology, Istanbul, TURKEY
2Kosuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, Istanbul, Turkey


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


METHODS
In this retrospective study, 131 patients with IE were enrolled. The PNI level of patients were evaluated besides baseline clinical and demographical variables. Patients were divided into two groups whether the presence of in-hospital mortality.


RESULTS
Twenty-nine patients died during the median follow-up of 37 days. The PNI was lower (35.90±6.96; 31.09±5.88, p=0.001) in patients with mortality. Receiver-operating characteristic analysis also demonstrated that PNI had good predictive value for in-hospital mortality with a cut-off value of 35.6 (AUC: 0.691, 95% CI: 0.589-0.794, p=0.002). In multivariate logistic regression analysis, advanced age (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 perforation (OR=5.557; 95%CI=1.357-22.765; p=0.017) were found to be independent predictors of mortality. Additionally, Kaplan-Meier survival analysis revealed that long term survival was found to be significantly decreased in patients with lower PNI (Log Rang p=0.008).


CONCLUSION
PNI was associated with increased in-hospital mortality rates in patients with IE. PNI, advanced age and 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

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Corresponding Author: Serkan Kahraman, Türkiye
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