预后营养指数对老年重症COPD病人预后的预测价值

Predictive value of prognostic nutritional index for the prognosis of elderly patients with severe chronic obstructive pulmonary disease

目的探讨预后营养指数(PNI)预测老年重症COPD病人预后的价值。方法回顾性分析2016年1月至2019年12月扬州大学附属医院收治的132例老年重症COPD病人的临床资料,采用ROC曲线判断PNI与病人预后相关性并计算最佳截断值,通过电话回访病人入院6个月后是否生存,分为死亡组和存活组,比较2组病人临床指标。采用COX回归模型和Kalan-Meier曲线探究PNI与老年COPD重症病人生存不良预后的关系。结果最终纳入132例病人,死亡组72例,存活组60例,PNI的最佳截断值为37.32。多因素COX回归分析提示,年龄、PNI<37.32、住院总时间是老年重症COPD病人死亡的独立影响因素,当PNI<37.32时,老年重症COPD病人死亡风险为对照组的2.281倍。结论PNI对老年重症COPD病人预后有预测价值,PNI<37.32预示预后不良。

Objective To explore the predictive value of prognostic nutritional index(PNI)for the prognosis of the elderly patients with severe chronic obstructive pulmonary disease(COPD).Methods A retrospective analysis of the clinical data of 132 elderly patients with severe COPD who were admitted into the Affiliated Hospital of Yangzhou University from January 2016 to December 2019 was conducted.The receiver operator characteristic(ROC)curve was used to analyze the correlation between PNI and the prognosis.The patients were divided into a death group and a survival group according to the survival 6 months later,and the differences in the levels of the clinical indicators were compared between the two groups.COX regression model and Kaplan-Meier curve were used to explore the relationship between PNI and the prognosis of the elderly patients with severe COPD.Results A total of 132 patients were included,with 72 cases in the death group and 60 cases in the survival group.The best cut-off value of PNI was 37.32.Multivariate COX regression analysis indicated that age,PNI<37.32 and total hospital stay were the independent prognostic factors for death in the elderly patients with severe COPD.Conclusions PNI shows predictive value for the prognosis of the elderly patients with severe COPD,and PNI<37.32 indicates poor survival.