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BMC Neurology
Published in: BMC Neurology 1/2021

Open Access 01-12-2021 | Cerebral Sinus Venous Thrombosis | Research

Prognostic nutritional index predicts clinical outcomes in patients with cerebral venous sinus thrombosis

Authors: Jiawei Zhao, Kai Liu, Shen Li, Yuan Gao, Lu Zhao, Hongbing Liu, Hui Fang, Jun Wu, Shilei Sun, Yusheng Li, Bo Song, Yuming Xu

Published in: BMC Neurology | Issue 1/2021

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Abstract

Background

Lower prognostic nutritional index (PNI) is related to the poor prognosis of cardiovascular diseases. However, little is known about PNI and its relationship with the prognosis of cerebral venous sinus thrombosis (CVST).

Methods

CVST patients were retrospectively identified from January 2013 till June 2019. Patients in the acute / subacute phase were selected as subjects. Poor prognosis was defined as a modified Rankin Scale (mRS) of 3–6. Multivariate logistic regression analysis was used to confirm if lower PNI was associated with a poor prognosis.

Results

A total of 297 subjects with follow-up data were enrolled. Thirty-three (11.1%) had a poor outcome. Multivariate logistic regression analysis suggested that PNI was an important predictive factor of poor outcome in acute/subacute CVST (odds ratio, 0.903; 95% CI, 0.833–0.978; P = 0.012). The optimal cut-off value for predicting the poor prognosis of PNI was 44.2. Kaplan-Meier analysis and log-rank test suggested that the lower the PNI value, the higher the mortality rate (P < 0.001). In addition, the nomogram that was set up showed that lower PNI was an index of poor prognosis. The c-index for acute/subacute patients with CVST was 0.872.

Conclusion

Lower PNI is correlated with a higher risk of adverse clinical outcomes in patients with acute/subacute CVST.
Appendix
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Literature
1.
Filippidis A, Kapsalaki E, Patramani G. Fountas KN cerebral venous sinus thrombosis: review of the demographics, pathophysiology, current diagnosis, and treatment. Neurosurg Focus. 2009;27(5):E3.PubMedCrossRef
2.
Medel R, Monteith SJ, Crowley RW. Dumont AS a review of therapeutic strategies for the management of cerebral venous sinus thrombosis. Neurosurg Focus. 2009;27(5):E6.PubMedCrossRef
3.
Chik Y, Gottesman RF, Zeiler SR, Rosenberg J. Llinas RH differentiation of transverse sinus thrombosis from congenitally atretic cerebral transverse sinus with CT. Stroke. 2012;43(7):1968–70.PubMedPubMedCentralCrossRef
4.
Saposnik G, Barinagarrementeria F, Brown RD Jr, Bushnell CD, Cucchiara B, Cushman M, et al. Diagnosis and management of cerebral venous thrombosis: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011;42(4):1158–92.PubMedCrossRef
5.
Ferro JM, Bousser MG, Canhao P, Coutinho JM, Crassard I, Dentali F, et al. European stroke organization guideline for the diagnosis and treatment of cerebral venous thrombosis - endorsed by the European academy of neurology. European Stroke J. 2017;2(3):195–221.CrossRef
6.
Coutinho JM, Zuurbier SM, Aramideh M. Stam J the incidence of cerebral venous thrombosis: a cross-sectional study. Stroke. 2012;43(12):3375–7.PubMedCrossRef
7.
Devasagayam S, Wyatt B, Leyden J. Kleinig T cerebral venous sinus thrombosis incidence is higher than previously thought: a retrospective population-based study. Stroke. 2016;47(9):2180–2.PubMedCrossRef
8.
Gulati D, Strbian D. Sundararajan S cerebral venous thrombosis: diagnosis and management. Stroke. 2014;45(2):e16–8.PubMedCrossRef
9.
Zhang X, Pang L, Sharma SV, Li R, Nyitray AG, Edwards BJ Malnutrition and overall survival in older patients with cancer. Clin Nutr. 2020.
10.
Adejumo AC, Adejumo KL, Adegbala OM, Enwerem N, Ofosu A, Akanbi O, et al. Inferior outcomes of patients with acute myocardial infarction and comorbid protein-energy malnutrition. JPEN J Parenter Enteral Nutr. 2020;44(3):454–62.PubMedCrossRef
11.
Cai ZM, Wu YZ, Chen HM, Feng RQ, Liao CW, Ye SL, et al. Being at risk of malnutrition predicts poor outcomes at 3 months in acute ischemic stroke patients. Eur J Clin Nutr. 2020;74(5):796–805.PubMedCrossRef
12.
Wang SH, Zhai ST. Lin H role of prognostic nutritional index in patients with gastric cancer: a meta-analysis. Minerva Med. 2016;107(5):322–7.PubMed
13.
Chen QJ, Qu HJ, Li DZ, Li XM, Zhu JJ, Xiang Y, et al. Prognostic nutritional index predicts clinical outcome in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Sci Rep. 2017;7(1):3285.PubMedPubMedCentralCrossRef
14.
Xiang W, Chen X, Ye W, Li J, Zhang X. Xie D prognostic nutritional index for predicting 3-month outcomes in ischemic stroke patients undergoing thrombolysis. Front Neurol. 2020;11:599.PubMedPubMedCentralCrossRef
15.
Li S, Liu K, Gao Y, Zhao L, Zhang R, Fang H, et al. Prognostic value of systemic immune-inflammation index in acute/subacute patients with cerebral venous sinus thrombosis. Stroke Vasc Neurol. 2020;5(4):368–73.PubMedPubMedCentralCrossRef
16.
Meng R, Wang X, Hussain M, Dornbos D 3rd, Meng L, Liu Y, et al. Evaluation of plasma D-dimer plus fibrinogen in predicting acute CVST. International journal of stroke : official journal of the International Stroke Society. 2014;9(2):166–73.CrossRef
17.
Li S, Liu K, Zhang R, Gao Y, Fang H, Liu X, et al. Lower lymphocyte to monocyte ratio is a potential predictor of poor outcome in patients with cerebral venous sinus thrombosis. Stroke Vasc Neurol. 2019;4(3):148–53.PubMedCrossRef
18.
Onodera T, Goseki N. Kosaki G [prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients]. Nihon Geka Gakkai Zasshi. 1984;85(9):1001–5.PubMed
19.
Ferro JM, Canhao P, Stam J, Bousser MG, Barinagarrementeria F. Investigators I prognosis of cerebral vein and dural sinus thrombosis: results of the international study on cerebral vein and Dural sinus thrombosis (ISCVT). Stroke. 2004;35(3):664–70.PubMedCrossRef
20.
Duman T, Demirci S, Uluduz D, Kozak HH, Demir S, Misirli CH, et al. Cerebral venous sinus thrombosis as a rare complication of systemic lupus Erythematosus: subgroup analysis of the VENOST study. Journal of Stroke Cerebrovascular Dis. 2019;28(12):104372.CrossRef
21.
Goeijenbier M, van Wissen M, van de Weg C, Jong E, Gerdes VE, Meijers JC, et al. Review: viral infections and mechanisms of thrombosis and bleeding. J Med Virol. 2012;84(10):1680–96.PubMedPubMedCentralCrossRef
22.
Rashad S, Niizuma K, Sato-Maeda M, Fujimura M, Mansour A, Endo H, et al. Early BBB breakdown and subacute inflammasome activation and pyroptosis as a result of cerebral venous thrombosis. Brain Res. 1699;2018:54–68.
23.
Wang L, Duan J, Bian T, Meng R, Wu L, Zhang Z, et al. Inflammation is correlated with severity and outcome of cerebral venous thrombosis. J Neuroinflammation. 2018;15(1):329.PubMedPubMedCentralCrossRef
24.
Aguiar DSD, Pereira-Santos MC, Serra-Caetano A, Lucas NL, Sousa AL, Gabriel D, et al. Blood biomarkers associated with inflammation predict poor prognosis in cerebral venous thrombosis:: a multicenter prospective observational study. Eur J Neurol 2020.
25.
Kobayashi N, Usui S, Kikuchi S, Goto Y, Sakai M, Onizuka M, et al. Preoperative lymphocyte count is an independent prognostic factor in node-negative non-small cell lung cancer. Lung Cancer. 2012;75(2):223–7.PubMedCrossRef
26.
Xiao J, Qiu QW, Qin C, Tao R, Qiao SY, Chen M, et al. Dynamic changes of peripheral blood lymphocyte subsets in acute ischemic stroke and prognostic value. Brain Behav. 2020:e01919.
27.
Prass K, Meisel C, Hoflich C, Braun J, Halle E, Wolf T, et al. Stroke-induced immunodeficiency promotes spontaneous bacterial infections and is mediated by sympathetic activation reversal by poststroke T helper cell type 1-like immunostimulation. J Exp Med. 2003;198(5):725–36.PubMedPubMedCentralCrossRef
28.
Prass K, Braun JS, Dirnagl U, Meisel C. Meisel a stroke propagates bacterial aspiration to pneumonia in a model of cerebral ischemia. Stroke. 2006;37(10):2607–12.PubMedCrossRef
29.
Haeusler KG, Schmidt WU, Fohring F, Meisel C, Helms T, Jungehulsing GJ, et al. Cellular immunodepression preceding infectious complications after acute ischemic stroke in humans. Cerebrovasc Dis. 2008;25(1–2):50–8.PubMedCrossRef
30.
Vogelgesang A, Grunwald U, Langner S, Jack R, Broker BM, Kessler C, et al. Analysis of lymphocyte subsets in patients with stroke and their influence on infection after stroke. Stroke. 2008;39(1):237–41.PubMedCrossRef
31.
Akboga YE, Bektas H. Anlar O usefulness of platelet to lymphocyte and neutrophil to lymphocyte ratios in predicting the presence of cerebral venous sinus thrombosis and in-hospital major adverse cerebral events. J Neurol Sci. 2017;380:226–9.PubMedCrossRef
32.
Artoni A, Abbattista M, Bucciarelli P, Gianniello F, Scalambrino E, Pappalardo E, et al. Platelet to lymphocyte ratio and neutrophil to lymphocyte ratio as risk factors for venous thrombosis. Clin Appl Thromb Hemost. 2018;24(5):808–14.PubMedCrossRef
33.
Franch-Arcas G. The meaning of hypoalbuminaemia in clinical practice. Clin Nutr. 2001;20(3):265–9.PubMedCrossRef
34.
Oduncu V, Erkol A, Karabay CY, Kurt M, Akgun T, Bulut M, et al. The prognostic value of serum albumin levels on admission in patients with acute ST-segment elevation myocardial infarction undergoing a primary percutaneous coronary intervention. Coron Artery Dis. 2013;24(2):88–94.PubMedCrossRef
35.
Bielewicz J, Kurzepa J, Czekajska-Chehab E, Kamieniak P, Daniluk B, Bartosik-Psujek H, et al. Worse neurological state during acute ischemic stroke is associated with a decrease in serum albumin levels. J Mol Neurosci. 2016;58(4):493–6.PubMedPubMedCentralCrossRef
36.
Kirsch R, Frith L, Black E. Hoffenberg R regulation of albumin synthesis and catabolism by alteration of dietary protein. Nature. 1968;217(5128):578–9.PubMedCrossRef
37.
Ishida S, Hashimoto I, Seike T, Abe Y, Nakaya Y. Nakanishi H serum albumin levels correlate with inflammation rather than nutrition supply in burns patients: a retrospective study. J Med Investig. 2014;61(3–4):361–8.CrossRef
38.
Eckart A, Struja T, Kutz A, Baumgartner A, Baumgartner T, Zurfluh S, et al. Relationship of nutritional status, inflammation, and serum albumin levels during acute illness: a prospective study. Am J Med. 2020;133(6):713–22 e717.PubMedCrossRef
39.
Joles JA, Willekes-Koolschijn N. Koomans HA Hypoalbuminemia causes high blood viscosity by increasing red cell lysophosphatidylcholine. Kidney Int. 1997;52(3):761–70.PubMedCrossRef
40.
Levitt DG. Levitt MD human serum albumin homeostasis: a new look at the roles of synthesis, catabolism, renal and gastrointestinal excretion, and the clinical value of serum albumin measurements. Int J Gen Med. 2016;9:229–55.PubMedPubMedCentralCrossRef
41.
Nozoe T, Ninomiya M, Maeda T, Matsukuma A, Nakashima H. Ezaki T prognostic nutritional index: a tool to predict the biological aggressiveness of gastric carcinoma. Surg Today. 2010;40(5):440–3.PubMedCrossRef
42.
Buzby GP, Mullen JL, Matthews DC, Hobbs CL. Rosato EF prognostic nutritional index in gastrointestinal surgery. Am J Surg. 1980;139(1):160–7.PubMedCrossRef
43.
Kim CY, Kim SY, Song JH, Kim YS, Jeong SJ, Lee JG, et al. Usefulness of the preoperative prognostic nutritional index score as a predictor of the outcomes of lung transplantation: a single-institution experience. Clin Nutr. 2019;38(5):2423–9.PubMedCrossRef
44.
Lin Y, Chen Q, Peng Y, Chen Y, Huang X, Lin L, et al. Prognostic nutritional index predicts in-hospital mortality in patients with acute type a aortic dissection. Heart Lung. 2021;50(1):159–64.PubMedCrossRef
Metadata
Title
Prognostic nutritional index predicts clinical outcomes in patients with cerebral venous sinus thrombosis
Authors
Jiawei Zhao
Kai Liu
Shen Li
Yuan Gao
Lu Zhao
Hongbing Liu
Hui Fang
Jun Wu
Shilei Sun
Yusheng Li
Bo Song
Yuming Xu
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2021
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-021-02436-w

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