摘要
Background:Burn injury in elderly patients can result in poor outcomes.Prognostic nutritional index(PNI)can predict the perioperative nutritional status and postoperative outcomes.We aim to evaluate the risk factors,including PNI,for one-year mortality after burn surgery in elderly patients.Methods:Burn patients aged≥65 years were retrospectively included.PNIwas calculated using the following equation:10×serum albumin level(g/dL)+0.005×total lymphocyte count(per mm3).Cox regression,receiver operating characteristic curve and Kaplan–Meier survival analyses were performed to evaluate the risk factors for postoperative one-year mortality.Results:Postoperative one-year mortality occurred in 71(37.6%)of the 189 elderly burn patients.Risk factors for one-year mortality were PNI on postoperative day one(hazard ratio(HR)=0.872;95%CI=0.812–0.936;p<0.001),Sequential Organ Failure Assessment score(HR=1.112;95%CI=1.005–1.230;p=0.040),American Society of Anesthesiologists physical status(HR=2.064;95%CI=1.211–3.517;p=0.008),total body surface area burned(HR=1.017;95%CI=1.003–1.032;p=0.015)and preoperative serum creatinine level(HR=1.386;95%CI=1.058–1.816;p=0.018).The area under the curve of PNI for predicting one-year mortality after burn surgery was 0.774(optimal cut-off value=25.5).Patients with PNI≤25.5 had a significantly lower one-year survival rate than those with PNI>25.5(32.1%vs 75.9%,p<0.001).Conclusions:PNI on postoperative day one was associated with postoperative one-year mortality in elderly burn patients.The postoperative one-year survival rate was lower in patients with PNI≤25.5 than in those with PNI>25.5.These findings indicate the importance of identifying elderly burn patients with low PNI,thereby reducing the mortality after burn surgery.
