ArticlePerioperative medicine (London, England)2021
The need for nutritional assessment and interventions based on the prognostic nutritional index for patients with femoral fractures: a retrospective study.
Article in Perioperative medicine (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed, 15 citations in OpenAlex.
- Risk factors for persistent wound drainage after hemiarthroplasty in elderly hip fracture patients.Joint diseases and related surgery · 2026Article
- A retrospective analysis of the link between the prognostic nutritional index and 1-year mortality rates in older adults suffering from femoral neck fractures.Frontiers in nutrition · 2026Article
- Association of Prognostic Nutritional Index and Mortality in Older Adults Undergoing Hip Fracture Surgery: A Retrospective Observational Study at a Single Large Center.Medicina (Kaunas, Lithuania) · 2025Observational
- Prognostic Nutritional Index Could Serve as a Reliable Prognostic Marker in Intensive Care Population.Medical sciences (Basel, Switzerland) · 2025Article
- Epidemiology, Controversies, and Dilemmas of Perioperative Nutritional Risk/Malnutrition: A Narrative Literature Review.Risk management and healthcare policy · 2025Review
- The relationship between prognostic nutritional index and its components (albumin and lymphocyte count) and all-cause mortality in lung cancer patients: a hospital-based study with database external validation.Frontiers in nutrition · 2025Article
- Targeted nutritional strategies in postoperative care.Anesthesia and pain medicine · 2025Review
- Observational
- Preoperative malnutrition as an independent risk factor for the postoperative mortality in elderly Chinese individuals undergoing hip surgery: a single-center observational study.Therapeutic advances in chronic disease · 2022Article
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Authors and funding
8 authors at 1 institution in 1 country.
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Abstract
backgroundThe incidence of adverse perioperative outcomes in surgery for femoral fractures is high and associated with malnutrition. Here, we identified independent factors and assessed the predictive value of the prognostic nutritional index (PNI) for perioperative adverse outcomes in patients with femoral fractures.
methodsThis retrospective study included 343 patients who underwent surgery for a single femur fracture. Demographic characteristics, surgery and anaesthesia records and blood test results at admission, 1 day postoperatively and before discharge were evaluated using logistic regression analysis. The discriminatory ability of the independent factors was assessed using the receiver operating characteristic curve analysis, and DeLong's test was used to compare the area under the curve (AUC).
resultsOverall, 159 patients (46.4%) experienced adverse perioperative outcomes. Amongst these, 123 (35.9%) had lower limb vein thrombus, 68 (19.8%) had hospital-acquired pneumonia, 6 (1.7%) were transferred to the postoperative intensive care unit, 4 (1.2%) had pulmonary embolism, 3 (0.9%) died during hospitalisation and 9 (2.6%) had other adverse outcomes, including incision disunion, renal and liver function impairment, acute heart failure, acute cerebral infarction and stress gastroenteritis. The PNI at admission, age, postoperative hospital stay, time to admission, hypertension, combined injures and surgery type were independent factors for adverse perioperative outcomes. Based on the AUC (PNI at admission: 0.772 [0.723-0.821], P < 0.001; age: 0.678 [0.622-0.734], P < 0.001; postoperative hospital stay: 0.608 [0.548-0.668], P = 0.001; time to admission: 0.585 [0.525-0.646], P = 0.006), the PNI at admission had optimal discrimination ability, indicating its superiority over other independent factors (age vs. PNI at admission, P = 0.002; postoperative hospital stay vs. PNI at admission, P < 0.001; time to admission vs. PNI at admission, P < 0.001).
conclusionsPatients with femoral fractures require a nutritional assessment and appropriate nutritional intervention at admission, and that the PNI value at admission may be a good nutritional assessment indicator.
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