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前白蛋白校正的预后营养指数可能预测髋部骨折患者的术后生存率和自由行走能力：一项多中心随访研究
Yue Zhang,1,* Daqian Yu,1,* Xian Xu,1 Yanping Guo,1 Zhibang Zhao,2 Shengchao Ji1
1Department of Traumatic Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200092, People’s Republic of China; 2Emergency Trauma Center, Nanyang Second People’s Hospital, Nanyang, Henan, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Shengchao Ji, Email 13918916261@163.com
Background: This multi-center study aims to develop and validate the Prealbumin-adjusted Prognostic Nutritional Index (PAPNI), hypothesizing that it would enhance prognostic prediction for hip fracture patients compared to traditional indices.
Methods: Data from 771 patients (Cohort 1) and 673 patients (Cohort 2) were retrospectively analyzed. The PAPNI was formulated by substituting albumin with prealbumin in the Prognostic Nutritional Index (PNI) formula, with its weight optimized using receiver operating characteristic (ROC) curves. All individuals were followed up for 1 year. The relationships between PAPNI and outcomes were explored.
Results: In both cohorts, PAPNI demonstrated superior predictive accuracy for 1-year mortality and free walking ability compared to PNI, prealbumin, and lymphocyte count alone. Patients with low PAPNI exhibited significantly higher mortality rates and lower free walking rates. Multivariate analyses confirmed PAPNI as an independent predictor for outcomes of hip fracture.
Conclusion: PAPNI, incorporating prealbumin, offers a more accurate and convenient method for predicting postoperative survival and functional recovery of hip fractures, providing a basis for early nutritional intervention.
Keywords: PAPNI, Hip fracture, prealbumin, outcomes
1Department of Traumatic Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200092, People’s Republic of China; 2Emergency Trauma Center, Nanyang Second People’s Hospital, Nanyang, Henan, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Shengchao Ji, Email 13918916261@163.com
Background: This multi-center study aims to develop and validate the Prealbumin-adjusted Prognostic Nutritional Index (PAPNI), hypothesizing that it would enhance prognostic prediction for hip fracture patients compared to traditional indices.
Methods: Data from 771 patients (Cohort 1) and 673 patients (Cohort 2) were retrospectively analyzed. The PAPNI was formulated by substituting albumin with prealbumin in the Prognostic Nutritional Index (PNI) formula, with its weight optimized using receiver operating characteristic (ROC) curves. All individuals were followed up for 1 year. The relationships between PAPNI and outcomes were explored.
Results: In both cohorts, PAPNI demonstrated superior predictive accuracy for 1-year mortality and free walking ability compared to PNI, prealbumin, and lymphocyte count alone. Patients with low PAPNI exhibited significantly higher mortality rates and lower free walking rates. Multivariate analyses confirmed PAPNI as an independent predictor for outcomes of hip fracture.
Conclusion: PAPNI, incorporating prealbumin, offers a more accurate and convenient method for predicting postoperative survival and functional recovery of hip fractures, providing a basis for early nutritional intervention.
Keywords: PAPNI, Hip fracture, prealbumin, outcomes