International Journal of Nutrition and Food Sciences

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Assessment of Nutritional Status and Prognosis in Surgical Intensive Care Unit: The Prognostic and Inflammatory Nutritional Index (PINI)

Received: 15 September 2014    Accepted: 23 September 2014    Published: 30 September 2014
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Abstract

Background Malnutrition is an independent factor of morbidity and mortality in patients at intensive care unit. The prognostic inflammatory and nutritional index (PINI) is frequently used as a marker of malnutrition but this scoring system was not studied in surgical intensive care units. The purposes of this study were to assist nutritional status with biomarkers and to search for a correlation between biological markers and prognosis, using the PINI. Methods A prospective, observational study was performed in the intensive care unit, started in July 2013. Twenty surgical patients, spent at least seven days at the intensive care unit were enrolled. An early nutritional care was given (first 24 hours). The patients were evaluated each week clinically and biologically (Albumin, Prealbumin, Orosomucoid, C-reactive protein) in order to establish the prognostic inflammatory and nutritional index (PINI = C-reactive protein x Orosomucoid / Albumin x Prealbumin). The correlation between variables was calculated, the Spearman rank-order correlation was used. Results The average age was 56+/-11 years, IGS II score was 48+/-17, APACHE II score was 25+/-12 and MODS ratio was 6+/-4. The mean duration of stay was 40+/-25 days, the mortality rate was 35%. The average calorie intake was 2300+/- 600 kcal. There was a weight gain and an increase of the Body Mass Index either in surviving and dead patients. There was an initial increase of the C-reactive protein and the orosomucoid rate during the acute phase of aggression followed by a progressive decrease. The nutritional proteins (albumin, prealbumin, retinol binding protein) were always low, despite a progressive increase. The PINI was initially high and decreased progressively but remained high (> 20).The Albumin and Prealbumin rate were correlated with the MODS ratio. There was a correlation between the orosomucoid rate and the organ failure. The PINI was correlated to the MODS ratio and to the IGS II but not with mortality. Conclusions The malnutrition in surgical patients at intensive care unit has an early onset and is always severe. Biological markers and PINI are correlated with organ failure but not with mortality.

DOI 10.11648/j.ijnfs.20140305.27
Published in International Journal of Nutrition and Food Sciences (Volume 3, Issue 5, September 2014)
Page(s) 477-483
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Nutrition Status, Inflammation, Biological Markers, Prognosis, Enteral Nutrition, Surgical Intensive Care Unit, PINI

References
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    Hedi Gharsallah, Zied Hajjej, Imen Naas, Zied Aouni, Nejla Stambouli, et al. (2014). Assessment of Nutritional Status and Prognosis in Surgical Intensive Care Unit: The Prognostic and Inflammatory Nutritional Index (PINI). International Journal of Nutrition and Food Sciences, 3(5), 477-483. https://doi.org/10.11648/j.ijnfs.20140305.27

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    ACS Style

    Hedi Gharsallah; Zied Hajjej; Imen Naas; Zied Aouni; Nejla Stambouli, et al. Assessment of Nutritional Status and Prognosis in Surgical Intensive Care Unit: The Prognostic and Inflammatory Nutritional Index (PINI). Int. J. Nutr. Food Sci. 2014, 3(5), 477-483. doi: 10.11648/j.ijnfs.20140305.27

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    AMA Style

    Hedi Gharsallah, Zied Hajjej, Imen Naas, Zied Aouni, Nejla Stambouli, et al. Assessment of Nutritional Status and Prognosis in Surgical Intensive Care Unit: The Prognostic and Inflammatory Nutritional Index (PINI). Int J Nutr Food Sci. 2014;3(5):477-483. doi: 10.11648/j.ijnfs.20140305.27

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  • @article{10.11648/j.ijnfs.20140305.27,
      author = {Hedi Gharsallah and Zied Hajjej and Imen Naas and Zied Aouni and Nejla Stambouli and Iheb Labbène and Mustapha Ferjani},
      title = {Assessment of Nutritional Status and Prognosis in Surgical Intensive Care Unit: The Prognostic and Inflammatory Nutritional Index (PINI)},
      journal = {International Journal of Nutrition and Food Sciences},
      volume = {3},
      number = {5},
      pages = {477-483},
      doi = {10.11648/j.ijnfs.20140305.27},
      url = {https://doi.org/10.11648/j.ijnfs.20140305.27},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijnfs.20140305.27},
      abstract = {Background Malnutrition is an independent factor of morbidity and mortality in patients at intensive care unit. The prognostic inflammatory and nutritional index (PINI) is frequently used as a marker of malnutrition but this scoring system was not studied in surgical intensive care units. The purposes of this study were to assist nutritional status with biomarkers and to search for a correlation between biological markers and prognosis, using the PINI. Methods A prospective, observational study was performed in the intensive care unit, started in July 2013. Twenty surgical patients, spent at least seven days at the intensive care unit were enrolled. An early nutritional care was given (first 24 hours). The patients were evaluated each week clinically and biologically (Albumin, Prealbumin, Orosomucoid, C-reactive protein) in order to establish the prognostic inflammatory and nutritional index (PINI = C-reactive protein x Orosomucoid / Albumin x Prealbumin). The correlation between variables was calculated, the Spearman rank-order correlation was used. Results The average age was 56+/-11 years, IGS II score was 48+/-17, APACHE II score was 25+/-12 and MODS ratio was 6+/-4. The mean duration of stay was 40+/-25 days, the mortality rate was 35%. The average calorie intake was 2300+/- 600 kcal. There was a weight gain and an increase of the Body Mass Index either in surviving and dead patients. There was an initial increase of the C-reactive protein and the orosomucoid rate during the acute phase of aggression followed by a progressive decrease. The nutritional proteins (albumin, prealbumin, retinol binding protein) were always low, despite a progressive increase. The PINI was initially high and decreased progressively but remained high (> 20).The Albumin and Prealbumin rate were correlated with the MODS ratio. There was a correlation between the orosomucoid rate and the organ failure. The PINI was correlated to the MODS ratio and to the IGS II but not with mortality. Conclusions The malnutrition in surgical patients at intensive care unit has an early onset and is always severe. Biological markers and PINI are correlated with organ failure but not with mortality.},
     year = {2014}
    }
    

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  • TY  - JOUR
    T1  - Assessment of Nutritional Status and Prognosis in Surgical Intensive Care Unit: The Prognostic and Inflammatory Nutritional Index (PINI)
    AU  - Hedi Gharsallah
    AU  - Zied Hajjej
    AU  - Imen Naas
    AU  - Zied Aouni
    AU  - Nejla Stambouli
    AU  - Iheb Labbène
    AU  - Mustapha Ferjani
    Y1  - 2014/09/30
    PY  - 2014
    N1  - https://doi.org/10.11648/j.ijnfs.20140305.27
    DO  - 10.11648/j.ijnfs.20140305.27
    T2  - International Journal of Nutrition and Food Sciences
    JF  - International Journal of Nutrition and Food Sciences
    JO  - International Journal of Nutrition and Food Sciences
    SP  - 477
    EP  - 483
    PB  - Science Publishing Group
    SN  - 2327-2716
    UR  - https://doi.org/10.11648/j.ijnfs.20140305.27
    AB  - Background Malnutrition is an independent factor of morbidity and mortality in patients at intensive care unit. The prognostic inflammatory and nutritional index (PINI) is frequently used as a marker of malnutrition but this scoring system was not studied in surgical intensive care units. The purposes of this study were to assist nutritional status with biomarkers and to search for a correlation between biological markers and prognosis, using the PINI. Methods A prospective, observational study was performed in the intensive care unit, started in July 2013. Twenty surgical patients, spent at least seven days at the intensive care unit were enrolled. An early nutritional care was given (first 24 hours). The patients were evaluated each week clinically and biologically (Albumin, Prealbumin, Orosomucoid, C-reactive protein) in order to establish the prognostic inflammatory and nutritional index (PINI = C-reactive protein x Orosomucoid / Albumin x Prealbumin). The correlation between variables was calculated, the Spearman rank-order correlation was used. Results The average age was 56+/-11 years, IGS II score was 48+/-17, APACHE II score was 25+/-12 and MODS ratio was 6+/-4. The mean duration of stay was 40+/-25 days, the mortality rate was 35%. The average calorie intake was 2300+/- 600 kcal. There was a weight gain and an increase of the Body Mass Index either in surviving and dead patients. There was an initial increase of the C-reactive protein and the orosomucoid rate during the acute phase of aggression followed by a progressive decrease. The nutritional proteins (albumin, prealbumin, retinol binding protein) were always low, despite a progressive increase. The PINI was initially high and decreased progressively but remained high (> 20).The Albumin and Prealbumin rate were correlated with the MODS ratio. There was a correlation between the orosomucoid rate and the organ failure. The PINI was correlated to the MODS ratio and to the IGS II but not with mortality. Conclusions The malnutrition in surgical patients at intensive care unit has an early onset and is always severe. Biological markers and PINI are correlated with organ failure but not with mortality.
    VL  - 3
    IS  - 5
    ER  - 

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Author Information
  • Université de Tunis El Manar, Faculté de Médicine de Tunis, H?pital militaire de Tunis, service d’anesthésie réanimation, 1008, Tunis, Tunisie

  • Université de Tunis El Manar, Faculté de Médicine de Tunis, H?pital militaire de Tunis, service d’anesthésie réanimation, 1008, Tunis, Tunisie

  • Université de Tunis El Manar, Faculté de Médicine de Tunis, H?pital militaire de Tunis, service d’anesthésie réanimation, 1008, Tunis, Tunisie

  • H?pital militaire de Tunis, service de biochimie, 1008, Tunis, Tunisie

  • H?pital militaire de Tunis, service de biochimie, 1008, Tunis, Tunisie

  • Université de Tunis El Manar, Faculté de Médicine de Tunis, H?pital militaire de Tunis, service d’anesthésie réanimation, 1008, Tunis, Tunisie

  • Université de Tunis El Manar, Faculté de Médicine de Tunis, H?pital militaire de Tunis, service d’anesthésie réanimation, 1008, Tunis, Tunisie

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