The Association between Prognostic Nutritional Index (PNI) and Intraoperative Transfusion in Patients Undergoing Hepatectomy for Hepatocellular Carcinoma: A Retrospective Cohort Study

Abstract

Background: PNI is significantly associated with surgical outcomes; however, the association between PNI and intraoperative transfusions is unknown. Methods: This study retrospectively analyzed 1065 patients who underwent hepatectomy. We divided patients into two groups according to the PNI (44) and compared their transfusion rates and surgical outcomes. We performed multivariate logistic and Cox regression analysis to determine risk factors for transfusion and the 5-year survival. Additionally, we found the net reclassification index (NRI) to validate the discriminatory power of PNI. Results: The PNI p = 0.035) and poor surgical outcomes, such as post hepatectomy liver failure (adjusted [OR]: 3.02, 95%CI: 1.87–4.87, p p p = 0.002) and 5-year survival (p = 0.004). Conclusions: Preoperative PNI <44 was significantly associated with higher transfusion rates and surgical outcomes.

Keywords

• prognostic nutritional index
• bleeding
• transfusion
• hepatectomy
• hepatocellular carcinoma