Prognostic nutritional ındex and ıts role in predicting early postoperative outcomes in neonates undergoing congenital heart surgery
Progress in Pediatric Cardiology, cilt.84, 2026 (ESCI, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 84
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.ppedcard.2026.101954
- Dergi Adı: Progress in Pediatric Cardiology
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, EMBASE
- Anahtar Kelimeler: Congenital heart disease (CHD) newborns, Postoperative outcomes, Prognostic nutritional index (PNI)
- Van Yüzüncü Yıl Üniversitesi Adresli: Evet
Özet
Background: Nutritional status significantly impacts postoperative outcomes, yet preoperative assessment methods for cardiac surgery are limited. The prognostic nutritional index (PNI), which is calculated from serum ALB and lymphocyte counts, reflects both nutritional status and systemic inflammation. Objectives: This study aimed to evaluate the predictive value of the PNI for early postoperative outcomes in neonates undergoing congenital heart disease (CHD) surgery. Methods: A retrospective analysis of 146 cardiac surgery patients was performed. Patients were classified into survivors (Group I, n = 116) and nonsurvivors (Group II, n = 30) on the basis of in-hospital mortality. The primary outcomes included mortality and major complications (sepsis/pneumonia, low cardiac output syndrome [LCOS], and multiple organ dysfunction syndrome [MODS]). The secondary outcomes were prolonged mechanical ventilation (>7 days) and length of stay in the ICU. Multivariate logistic regression adjusted for confounders. Results: Survivors had a significantly greater PNI (45.74 ± 0.65 vs. 41.77 ± 1.47, p = 0.008). A PNI threshold of 41.675 was used to predict mortality (AUC = 0.683, p = 0.002). A lower PNI was linked to increased mortality (35.1% vs. 11.2%, p = 0.001) and higher complication rates (LCOS 10.5% vs. 6.7%, p = 0.0001; MODS 7% vs. 2.2%, p = 0.047; sepsis/pneumonia 33.3% vs. 7.9%, p = 0.0001). PNI was inversely correlated with hospital (r = −0.304, p = 0.0001) and ventilation duration (r = −0.169, p = 0.041). Multivariate analysis confirmed that a PNI > 41.675 was an independent predictor of survival (OR: 0.234, p < 0.001). Conclusion: The PNI is a valuable preoperative tool for predicting early outcomes in neonates undergoing CHD surgery, assisting in risk stratification and patient management.