Can the preoperative nutritional risk score be a predictor of the outcomes in critically ill patients of lung transplantation: a retrospective study

Kongmiao Lu, Huixing Li, Yinglun Chen, Bo Wu, Ji Zhang, Man Huang, Jingyu Chen


Background: Nutritional Risk Screening 2002 (NRS2002) and prognostic nutrition index (PNI) are nutritional risk screening instruments that are also used to predict the complications and morbidity after surgery. Our study aims to evaluate whether preoperative nutrition status at admission or postoperative nutrition treatment during admission for lung transplantation (LTX) was linked to clinical outcomes.
Methods: This study is a retrospective observational cohort study of 42 patients undergoing LTX. Using PNI and NRS-2002 screening instruments, patients were tested for dietary danger upon admission. Univariate and multivariate analyzes were performed to investigate the independent nutritional risk predictive value for post-operative complications, hospital length or intensive care unit (ICU) stay, and mortality.
Results: Age, the average calorie intake, parenteral nutrition within 7 days, furosemide, the time of postoperative mechanical ventilation (MV), postoperative extracorporeal membrane oxygenation (ECMO) between survivor and non-survivor had a significant difference. Univariate analyses of death in LTX, age [HR 1.06 (1.00–1.13), P=0.04], the average calorie intake first 3 days [HR 0.99 (0.99–1.00), P=0.02], parenteral nutrition within 7 days [HR 0.20 (0.05–0.77), P=0.02], furosemide [HR 0.08 (0.01–0.76), P=0.02] and postoperative ECMO [HR 6.40 (1.65–24.77), P=0.00] were independent predictors for increased mortality. And multivariate analyses found that only postoperative ECMO [HR 9.59 (1.07–86.13), P=0.04] was independent predictors for increased mortality, whereas PNI and NRS2002 were not.
Conclusions: PNI and NRS2002 was not an independent predictor for post-operative mortality, and postoperative ECMO was only independent predictors for increased mortality in this study.