The merits of the prognostic nutritional index and neutrophil-to-lymphocyte ratio in predicting outcomes of coronary artery bypass grafting: a retrospective cohort study.
Coronary artery bypass grafting (CABG) carries a risk for serious adverse events. The Prognostic Nutritional Index (PNI) and Neutrophil-to-Lymphocyte Ratio (NLR), are simple measures of nutritional and inflammatory statuses, have been proposed as a potential predictor of postoperative outcomes. This study aimed to assess the predictive performance of preoperative PNI and NLR and their dynamic changes for post-CABG outcomes.
The study investigated the medical records of 327 patients who underwent CABG between February 20, 2020, and February 19, 2025.
The overall complication and mortality rates were 15%, and 3.36% respectively. The preoperative PNI decreased significantly (P1 < 0.001) at 24-h postoperative and at the time of discharge. At the time of discharge, the mean PNI value increased significantly (P2 < 0.001) compared to that determined at 24-h postoperative. The magnitude of ∆PNI at discharge was significantly smaller than that at 24-h postoperatively (P3 < 0.001). Multivariate binary logistic regression identified preoperative PNI as an independent predictor of 1-month mortality, while ΔPNI at 24 h was independently associated with 1-month mortality.
PNI is a simple and inexpensive marker that may serve as a potential predictor of short-term outcomes after CABG. Lower preoperative PNI and greater early postoperative PNI decline were associated with adverse short-term outcomes after CABG, whereas preoperative NLR did not retain independent significance after multivariable adjustment; however, further prospective multicenter studies are required to confirm these findings.
The study investigated the medical records of 327 patients who underwent CABG between February 20, 2020, and February 19, 2025.
The overall complication and mortality rates were 15%, and 3.36% respectively. The preoperative PNI decreased significantly (P1 < 0.001) at 24-h postoperative and at the time of discharge. At the time of discharge, the mean PNI value increased significantly (P2 < 0.001) compared to that determined at 24-h postoperative. The magnitude of ∆PNI at discharge was significantly smaller than that at 24-h postoperatively (P3 < 0.001). Multivariate binary logistic regression identified preoperative PNI as an independent predictor of 1-month mortality, while ΔPNI at 24 h was independently associated with 1-month mortality.
PNI is a simple and inexpensive marker that may serve as a potential predictor of short-term outcomes after CABG. Lower preoperative PNI and greater early postoperative PNI decline were associated with adverse short-term outcomes after CABG, whereas preoperative NLR did not retain independent significance after multivariable adjustment; however, further prospective multicenter studies are required to confirm these findings.