Prognostic nutritional index predicts in-hospital mortality in patients with acute type A aortic dissection

Background The prognostic nutritional index (PNI) has recently been reported to associate with the surgical prognosis of patients with some cardiovascular diseases. However, the prognosis significance of the preoperative PNI in patients with acute type A aortic dissection (AAAD) remains unclear. Objectives The present study aimed to explore the relationship between PNI and postoperative in-hospital mortality in patients with AAAD. Methods Between June 2013 and December 2019, we retrospectively reviewed the clinical data of 651 patients undergoing AAAD surgery. Patients were divided into two groups according to the median PNI. The risk factors of postoperative in-hospital mortality were identified by univariate and multivariate logistic regression analysis. Results In-hospital mortality was significantly more common in the low group (24.8% vs 16.3%: P = .007). The percentage of prolonged mechanical ventilation (58.9% vs 49.8%: P = .020) and the median duration of intensive care unit stays (7.0 vs 6.0 days: P = .003) were also higher and longer in the low group. Multivariate logistic regression analysis showed that the PNI, age, hypertension, and operation time independently predicted in-hospital mortality. Besides, compared with patients with a history of hypertension, the low PNI affected in-hospital mortality more than those without (odds ratio [OR]: 2.07; 95% confidence interval [CI]: 1.20-3.56; P = .009). Conclusions Lower PNI may be independently associated with in-hospital mortality of patients after AAAD surgery.