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At least 19 recordsLinked to original sources
PubMed2006

The SCREEN I (Seniors in the Community: Risk Evaluation for Eating and Nutrition) index adequately represents nutritional risk.

OBJECTIVE: Nutrition risk is a difficult and complex construct to define and measure. Exploratory factor analysis has been completed on SCREEN I, a nutrition risk screening index for community-living seniors. This analysis was completed to confirm this structure and further validate the index as a plausible measure of nutritional risk. STUDY DESIGN AND SETTING: As part of the Bringing Nutrition Screening to Seniors demonstration project, 1,218 seniors completed SCREEN I. Using structural equation modeling (Amos version 5 software), the original and alternative two-, three-, and four-factor structures were modeled and compared. RESULTS: The best-fitting model was a four-factor structure based on the original exploratory model. Unlike the original model, however, several SCREEN I items cross-loaded on more than one factor, demonstrating the complexity of the construct 'nutritional risk.' CONCLUSION: SCREEN I appears to represent adequately the construct 'nutritional risk' with four factors: Food Intake, Physiologic, Adaptation, and Functional. Further work should be conducted to further elucidate the complex nature of 'nutritional risk' by identifying indirect and direct relationships among the screen items and this construct.

Aged↗
PubMed1984

[Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients].

Based on assessment of 200 malnourished cancer patients of digestive organs, a multiparameter index of nutritional status was defined to relating the risk of postoperative complications to base line nutritional status. The linear predictive model relating the risk of operative complication, mortality or both to nutritional status is given by the relation: prognostic nutritional index (PNI) = 10 Alb. + 0.005 Lymph. C., where Alb. is serum albumin level (g/100 ml) and Lymph. C. is total lymphocytes count/mm3 peripheral blood. When applied prospectively to 189 gastrointestinal surgical patients those who were malnourished and treated by TPN preoperatively, this index provided an accurate, quantitative estimate of operative risk. In general, resection and anastomosis of gastrointestinal tract can be safely practiced when the index is over 45. The same procedure may be dangerous between 45 and 40. In below 40, this kind of operation may be contraindicated. The prognostic nutritional index is useful also to know the prognosis of patients with terminal cancer. Despite practicing TPN to cancer patients with near terminal stages, if the PNI remains below 40 and total lymphocytes count remains below 1,000/mm3, the patients has high possibility to die within the next two months.

Digestive System Neoplasms↗
PubMed1987

The well-balanced diet and the "at risk" micronutriments: a forecasting nutritional index.

The forecasting nutritional index is the list of micronutrients whose intakes do not amount to 80% of the recommended allowances, this list being determined on the basis of a balanced diet. This kind of diet allows to bring out the micronutriments which are the least likely to be found in the diet. The food and epidemiological studies results allow to confirm the forecasting nature of this index.

Diet↗
PubMed1991

The prognostic inflammatory and nutritional index in traumatized patients receiving enteral nutrition support.

The prognostic inflammatory and nutritional index (PINI) is a clinical assessment tool which aggregates serum C-reactive protein (CRP), alpha 1-acid glycoprotein (AAG), prealbumin (PA), and albumin (ALB) concentrations into a single score. This study was conducted to characterize the index and its determinants over time in 15 critically ill trauma patients receiving enteral nutritional support (ENS). Patients received 1.4 g of protein/kg/day and 32 kcal/kg/day for at least 7 days using a nutritionally complete formula supplemented with whey protein. The PINI was calculated at baseline and on days 4, 7, 10, 14, 21, and 28. The PINI decreased significantly from baseline (186 +/- 202) to day 4 (116 +/- 86) and reached a nadir at day 14 (27 +/- 40). Serum CRP concentrations decreased significantly during the study period, while PA and ALB concentrations increased significantly. There was no change in the AAG concentration. Nitrogen balance increased significantly during the study period. The PINI was positively correlated with CRP concentration (r = 0.72, p = 0.0001) and negatively correlated with PA concentration (r = 0.56, p = 0.0004 and nitrogen balance (r = -0.51, p = 0.0018). The PINI decreased significantly during ENS of critically ill trauma patients, influenced primarily by a decrease in CRP concentration. Further studies are needed to characterize the PINI's performance as a prognostic tool.

Adolescent↗
PubMed2002

Assessment of nutritional status and prognosis in advanced cancer: interleukin-6, C-reactive protein, and the prognostic and inflammatory nutritional index.

The Prognostic Inflammatory Nutritional Index (PINI) is a simple scoring system that has been used to evaluate nutritional status and prognosis in critically ill patients. The PINI has never been evaluated in advanced cancer. Fifty consecutive patients with advanced cancer, weight loss, and anorexia were studied. C-reactive protein (CRP), albumin, pre-albumin, interleukin-6 (IL-6), and alpha 1-acid glycoprotein (AAG) were evaluated. The individual values for AAG, CRP, and IL-6 were markedly elevated. In contrast to albumin and prealbumin, CRP levels were very high. The PINI was significantly elevated, and higher than reported in critically ill intensive care patients. Elevated IL-6 levels correlated with high PINI and CRP values. CRP, IL-6, and PINI should be considered in future research on nutritional status and prediction of prognosis in advanced cancer.

Aged↗
PubMed1980

Prognostic nutritional index in gastrointestinal surgery.

Based on assessment of 161 nonemergency general surgical patients, a multiparameter index of nutritional status was defined relating the risk of postoperative complications to baseline nutritional status. When applied prospectively to 100 gastrointestinal surgical patients, this index provided an accurate, quantitative estimate of operative risk, permitting rational selection of patients to receive preoperative nutritional support.

Digestive System Surgical Procedures↗
PubMed1983

[New nutritional index for preoperative evaluation of malnutrition as a risk factor in surgery].

In a retrospective trial preoperative anthropometric and biochemical dates of 72 cancer patients were measured. All patients underwent a major surgical resection. Discriminant analysis and a computer-based stepwise regression procedure were used to identify the most important variables. It was able to compute a linear predictive model of 7 variables, called Nutritional Index, relating risk of operative mortality to preoperative nutritional status. In a prospective control trial it was possible to confirm the predictive value of the Nutritional Index by nutritional assessment of 204 surgical patients undergoing a major surgical procedure. This Nutritional Index provides a quantitative classification in surgical patients at high, low and without increased risk of nutritionally based complications.

Female↗
PubMed1995

Preoperative nutritional status and prognostic nutritional index in patients with benign disease undergoing abdominal operations--Part II.

OBJECTIVES: Part II of this study was undertaken to develop a prognostic nutritional index for the identification of high risk patients with benign disease undergoing abdominal operations at the Universitas Hospital in Bloemfontein. METHODS: To accomplish this goal, 52 consecutive adult non-cancer surgical patients, admitted to the Universitas Hospital for a period of one year, were studied prospectively. The postoperative outcome was monitored until discharge or death. Various discriminant analyses were performed on the obtained data. Four prognostic indexes were compiled, including two nutritional and two mixed models. A short and medium length index were derived for both the nutritional and the mixed models. RESULTS/DISCUSSION: The results suggest that the short nutritional index may be the most practical for the prediction of surgical outcome in this specific set of patients. The short nutritional index included diet risk, serum albumin, body mass index, % ideal body weight, triceps skinfold and grip strength. It is further suggested that these indices be tested in another set of patients and be compared with other available prognostic models.

Abdomen↗
PubMed2000

Prognostic nutritional index in relation to hospital stay in women with gynecologic cancer.

OBJECTIVE: To estimate the prevalence of malnutrition, correlate it with length of hospital stay, and evaluate laboratory tools to define it in gynecologic oncology. METHODS: Sixty-seven consecutive hospitalized gynecologic oncology patients were evaluated prospectively using the standardized Prognostic Nutritional Index method, based on serum albumin, transferrin, triceps skin fold and skin sensitivity tests, which defines criteria for malnourished and nourished patients. It was correlated with length of hospital stay. The Mann-Whitney test and Pearson's correlation coefficient were used to evaluate statistical relationships. RESULTS: Cancer distribution among study subjects was 39 cervical (58%), 16 uterine (24%), 11 ovarian (16%), and one vulvar (2%). Malnutrition was found in 36 of 67 women (54%; 95% confidence interval [CI] 41%, 66%). The median (interquartile range) hospital stays of nourished women (n = 31) and malnourished women (n = 36) were 6 (range 4-7) days and 8 (range 6-16) days, respectively (two-sided P =.004). That difference remained after controlling for age, extent of metastases, and cancer sites. Albumin correlated well with Prognostic Nutritional Index (R = -.78; 95% CI -.86, -.66; P <.001). Albumin also correlated with length of hospital stay R = -.41; 95% CI -.56, -.25; P <.001). CONCLUSION: Malnutrition is common in gynecologic oncology patients and contributes to longer hospital stays. Albumin is a good substitute for the Prognostic Nutritional Index laboratory test for assessing malnutrition.

Adult↗
PubMed1990

[Nutritional index in heart diseases in childhood].

PURPOSE: To study heart disease in childhood aiming to know its incidence and consequences upon the nutritional status. PATIENTS AND METHODS: Two-hundred patients were distributed in three groups: 1) 113 (56.5%) with congenital acyanotic form; 2) 19 (9.5%) with congenital cyanotic form and 3) 68 (34%) with acquired forms. All of them regularly visiting the ambulatory service of Paediatric cardiology of the Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da USP from 1987 until 1990. RESULTS: The majority (92%) of the children (being 56% male and aging 5.1 +/- 0.4 years-old) showed nutritional indexes between 5 and 95 (percentile scale). The overall diagnosis distribution were: 1) ventricular septal defect (51 cases); 2) atrial septal defect (21 cases); 3) valvular diseases (21 cases); 4) arrhythmias (20 cases); 5) cardiac involvement of systemic diseases (20 cases); and 6) tetralogy complex (8 cases). Twelve patients (6%) were underscored (below percentile 5) and only 4 (2%) scored above percentile 95 (obese patients). The comparison of the mean indexes were found statistical different (p less than 0.05), being the cyanotic congenital forms the worst ones and the acquired forms the best one. CONCLUSION: Heart disease in childhood is associated to nutritional index deficits in the majority of the cases.

Body Height↗
PubMed1985

A prognostic inflammatory and nutritional index scoring critically ill patients.

A new prognostic inflammatory and nutritional index is described allowing the correct follow-up of most pathological conditions. Discriminant analysis of eleven currently utilized blood markers of the phlogistic reaction and of the nutritional status has afforded the selection of the two most reliable acute-phase reactants (orosomucoid and C-reactive protein) and visceral proteins (albumin and prealbumin). These parameters are combined in a simple formula which consistently and accurately stratifies critically ill patients by risk of complications or death. The grading system is determined by a rapid and inexpensive micromethod encompassing both infectious and nutritional poles of the disease spectrum within a self-explanatory scale. The scoring system provides a more sensitive tool for the diagnosis and prognosis of stressed patients than any other method available to date.

Acute Disease↗
PubMed1998

Usefulness of the prognostic inflammatory and nutritional index (PINI) in hospitalized elderly patients.

The prognostic inflammatory and nutritional index (PINI) is a simple scoring system of overall health which aggregates two blood markers of inflammatory (C-reactive protein and alpha(1)-acid glycoprotein) and of nutritional (albumin and transthyretin) states. This study was undertaken with a view to evaluate, in comparison to currently used predictive approaches, the potential usefulness of PINI to forecast hospital mortality and outcome of patients hospitalized in an acute geriatric unit. 1,066 elderly patients, aged 82.7 +/- 6.6 years and fulfilling inclusion criteria, were enrolled in the study. Logistic regression analysis and calculation of relative risk (RR) were carried out for epidemiological data with a cut-off value of 25 for PINI. Immediate mortality (7.9%) of admissions) was predicted by PINI > or = 25 (RR = 4.34). Only 387 patients (36.3%) could rejoin their residence location (home or family). A sizeable proportion of acute patients (55.8%) failed to recover and/or developed diseased states requiring chronic care management. Incapacity to return home was predicted by PINI > or = 25 (RR = 2.04). Hypoalbuminaemia < or = 30 g/L was not found a predictor of mortality but was associated with total disability (RR = 9.08). The optimal PINI cut-off value to predict mortality was calculated at 8.8 using the ROC analytic approach. We conclude that the PINI formula is helpful to predict both nearest lethality and chronic institutionalization. This scoring system should take a place within the battery of tests used to identify and to follow up acutely ill elderly patients at risk of major complications.

Aged↗
PubMed2002

The cancer anorexia-cachexia syndrome: a survey of the Prognostic Inflammatory and Nutritional Index (PINI) in advanced disease.

Other than weight loss, most traditional methods of nutritional assessment are not acceptable in advanced cancer patients because they are inaccurate, too expensive for routine use, or too difficult for a debilitated person to complete. The prognostic inflammatory and nutritional index (PINI) is a formula devised to evaluate nutritional status and prognosis in critically ill patients. It has been suggested that the PINI score can be used to follow most pathological conditions. It has been measured in several settings and has been found to be a reliable indicator of both nutritional status and prognosis in trauma, burn, infected, and cardiac patients. In this pilot study, we evaluated the PINI in 50 consecutive patients referred to a palliative care service. Compared to a value in normal, healthy people of <1, the mean score in this sample was 102 (SD = 142, 95% CI = 62-142). The mean protein values were: alpha-1-acid glycoprotein 1409 mg/l (SD = 556, 95% CI = 1251-1567); C-reactive protein (CRP) 106 mg/l (SD = 89, 95% CI = 81-131); albumin 24 g/l (SD = 7, 95% CI = 23-26); and prealbumin 147 mg/l (SD = 73, 95% CI = 126-168). There was no significant association between the PINI and corticosteroid use, weight loss over time, age, or sex. These data indicate that the PINI is highly abnormal in our population. The CRP may be the most important value.

Aged↗
PubMedDate not supplied

Optimal nutritional indexes in cancer patients.

This paper reviews various parameters that are used to assess the nutritional and functional status of cancer patients. Available information shows that the nutritional status of cancer patients is correlated with their overall prognosis and outcome. However, little information exists concerning the use of nutritional indexes to evaluate the effectiveness of nutritional rehabilitation of cancer patients. It is emphasized that we should concentrate on developing nutritional parameters to assess the functional improvement of patients rather than their body structure and composition.

Humans↗
PubMed2003

The impact of nutrition intervention on a reliable morbidity and mortality indicator: the hemodialysis-prognostic nutrition index.

OBJECTIVE: To determine the prevalence of risk for hospitalization in hemodialysis (HD) patients and examine the impact of oral kilocalorie and protein supplementation in two Midwestern outpatient dialysis centers. DESIGN/SETTING: This was a prospective intervention study conducted at 2 outpatient dialysis centers in the Midwest. PATIENTS: The inclusion criteria for patients were (1) more than 18 years of age, (2) receiving HD 3 times per week, and (3) a functioning gastrointestinal tract. INTERVENTION: Patients who met study criteria and signed an informed consent form were screened using the hemodialysis prognostic nutrition index (HD-PNI) to determine risk for hospitalization. Patients determined to be at high risk (HD-PNI > or =0.8) were included in the treatment group, and patients at low risk did not receive the intervention. They followed their normal nutritional regimen. The intervention group received an oral supplement daily for 3 months. The team of the dietitian, patient, researcher, and physician determined the type of oral supplements based on patient needs and preferences. MAIN OUTCOME MEASURES: Before and after HD-PNI, 24-hour recall and subjective global assessments (SGA) were conducted to assess risk for hospitalization, dietary intake, and nutritional status, respectively. RESULTS: A total of 117 patients were screened, with a total of 26 in the treatment group (high risk) and 91 in the low-risk group. Baseline SGA distribution was 23% for patients with low nutritional risk (group A), 64% for those with moderate nutritional risk (group B), and 13% for those with severe nutritional risk (group C). When the HD-PNI scores of the treatment group were analyzed using paired t-tests, significant differences were observed between pre- and post-HD-PNI mean scores, 1.92 +/- 1.16 and 1.42 +/- 1.59, (P <.05) respectively. When comparing the responders versus the nonresponders by the dependent and independent variables (pre- and post-HD-PNI, SGA, kilocalorie intake, diabetic status, and presence of hypertension) only post-HD-PNI score was significantly different (0.96 +/- 1.69 and 2.20 +/- 1.09, respectively). CONCLUSION: This study succeeded in showing that 22% of the hemodialysis patients in 2 Midwestern centers were at an increased risk for hospitalization. Furthermore, dietitian intervention with oral kilocalorie and protein supplements decreased the patients' hemodialysis prognostic nutrition index scores and thereby decreased the patients' risks for hospitalization.

Aged↗
PubMed1998

Using the hemodialysis prognostic nutrition index and urea reduction ratio to predict morbidity and mortality: a pilot study of the 1995 council on renal nutrition national research question.

OBJECTIVE: To validate the use of the hemodialysis prognostic nutrition index (HPNI) in an alternate hemodialysis population and to determine if use of urea reduction ratio would improve use in outcome prediction for morbidity and mortality. DESIGN: Prospective random cohort. SETTING: Hospital based non-for-profit outpatient dialysis unit. PATIENTS: Forty chronic hemodialysis patients, 50% men, 50% black, 16% diabetic, 67.2 mean months on hemodialysis, mean age 54.5 years. INTERVENTIONS: None; observational; tracking of routinely collected demographic, biochemical, and clinical data. MAIN OUTCOME MEASURES: Number of times and days hospitalized, mortality RESULTS: Plotting of HPNI against urea reduction ratio produced risk quadrants for hospitalization that were more predictive than HPNI alone. CONCLUSION: Application continues as a multicenter collaborative Council on Renal Nutrition National Research Question.

Adolescent↗