Prognostic Nutritional Index as a Predictor of Mortality in Hospitalized Geriatric Patients with Chronic Atrial Fibrillation

Fatih Türker,1 Atay Can Kula,2 Mehmet Yamak,1 Vildan Söğüt Karayiğit,1 Alihan Oral,3 Pınar Doğan,1 Betül Çavuşoğlu Türker1 1Department of Internal Medicine, Haseki Health Training and Research Hospital, University of Health Sciences, İstanbul, Turkey; 2Department of Internal Medicine, Balıkesir University Medical Faculty, Balıkesir, Turkey; 3Department of Internal Medicine, Biruni University, İstanbul, TurkeyCorrespondence: Fatih Türker, Department of Internal Medicine, Haseki Health Training and Research Hospital, University of Health Sciences, Dr. Adnan Adıvar Cd. No: 9, İstanbul, 34130, Turkey, Tel +905364721656, Fax +902124532000, Email [email protected]: Internal medicine departments manage a broad spectrum of chronic diseases, which are frequently associated with higher mortality rates. In this context, we evaluated the relationship between the Prognostic Nutritional Index (PNI) and mortality in elderly inpatients with chronic atrial fibrillation (AF) admitted to an internal medicine department.Patients and Methods: This study included 158 hospitalized patients who were followed for five years post-discharge. We compared the following variables between the survival and non-survival groups: age, sex, presence of diabetes mellitus, hypertension, coronary artery disease, anticoagulant use, Prognostic Nutritional Index (PNI) score, CHA2DS2-VASc score, HAS-BLED score, ejection fraction (EF%), and laboratory parameters including neutrophil count, lymphocyte count, glucose, urea, alanine aminotransferase (ALT), hemoglobin, C-reactive protein (CRP), albumin, total cholesterol, thyroid-stimulating hormone (TSH), free T3, and ferritin levels.Results: When compared to the surviving patients, the patients who died were older (p = 0.001) and had a lower PNI scores (p = 0.011) Moreover the patients who died also had significantly higher total cholesterol and urea, levels and significantly lower Free T3 and albumin levels. The multivariate analysis revealed that the PNI score and urea level were significant independent factors in differentiating deceased patients from survivors (p < 0.05). The PNI score demonstrated a significant effect in distinguishing between non-survivors and survivors (Area under the curve (AUC)= 0.662).Conclusion: The PNI score have indicated the clinical importance of as a novel marker for predicting mortality in geriatric chronic AF patients.Keywords: PNI score, mortality, chronic atrial fibrillation