The prognostic inflammatory and nutritional index in traumatized patients receiving enteral nutrition support

Kathryn L. Vehe, Rex Brown, David A. Kuhl, Bradley Boucher, R. Wayne Lutherou, Kenneth A. Kudsk

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

The prognostic inflammatory and nutritional index (PINI) is a clinical assessment tool which aggregates serum C-reactive protein (CRP), a,-acid glycoprotein (AAG), prealbumin (PA), and albumin (ALB) concentrations into a single score. This study was conducted to characterize the index and its determinants over time in 15 critically ill trauma patients receiving enteral nutritional support (ENS). Patients received 1.4 g of protein/kg/day and 32 kcal/kg/day for at least 7 days using a nutritionally complete formula supplemented with whey protein. The PINI was calculated at baseline and on days 4,7,10,14, 21, and 28. The PINI decreased significantly from baseline (186 ± 202) to day 4 (116 ± 86) and reached a nadir at day 14 (27 ± 40). Serum CRP concentrations decreased significantly during the study period, while PA and ALB concentrations increased significantly. There was no change in the AAG concentration. Nitrogen balance increased significantly during the study period. The PINI was positively correlated with CRP concentration (r = 0.72, p = 0.0001) and negatively correlated with PA concentration (r = -0.56, p = 0.0004 and nitrogen balance (r = -0.51, p = 0.0018). The PINI decreased significantly during ENS of critically ill trauma patients, influenced primarily by a decrease in CRP concentration. Further studies are needed to characterize the PINI’s performance as a prognostic tool. Abbreviations: AAG = a,-acid glycoprotein, All = APACHE II score, ALB = albumin, ANOVA = analysis of variance, Cl = catabolic index, CRP = C-reactive protein, ENS = enteral nutritional support, HPI = hospital prognostic index, ISS = injury severity score, LSD = least significant difference, NB = nitrogen balance, NPC = nonprotein kilocalories, PA = prealbumin, PINI = prognostic inflammatory and nutritional index, PNI = prognostic nutritional index, TS = trauma score, UUN = urine urea nitrogen

Original languageEnglish (US)
Pages (from-to)355-363
Number of pages9
JournalJournal of the American College of Nutrition
Volume10
Issue number4
DOIs
StatePublished - Aug 1 1991

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Nutrition Assessment
Enteral Nutrition
Prealbumin
C-Reactive Protein
Nutritional Support
Small Intestine
Albumins
Glycoproteins
Nitrogen
Acids
Critical Illness
Blood Proteins
Analysis of Variance
Wounds and Injuries
Lysergic Acid Diethylamide
Injury Severity Score
APACHE
Protein C
Urea
Urine

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

The prognostic inflammatory and nutritional index in traumatized patients receiving enteral nutrition support. / Vehe, Kathryn L.; Brown, Rex; Kuhl, David A.; Boucher, Bradley; Lutherou, R. Wayne; Kudsk, Kenneth A.

In: Journal of the American College of Nutrition, Vol. 10, No. 4, 01.08.1991, p. 355-363.

Research output: Contribution to journalArticle

Vehe, Kathryn L. ; Brown, Rex ; Kuhl, David A. ; Boucher, Bradley ; Lutherou, R. Wayne ; Kudsk, Kenneth A. / The prognostic inflammatory and nutritional index in traumatized patients receiving enteral nutrition support. In: Journal of the American College of Nutrition. 1991 ; Vol. 10, No. 4. pp. 355-363.
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abstract = "The prognostic inflammatory and nutritional index (PINI) is a clinical assessment tool which aggregates serum C-reactive protein (CRP), a,-acid glycoprotein (AAG), prealbumin (PA), and albumin (ALB) concentrations into a single score. This study was conducted to characterize the index and its determinants over time in 15 critically ill trauma patients receiving enteral nutritional support (ENS). Patients received 1.4 g of protein/kg/day and 32 kcal/kg/day for at least 7 days using a nutritionally complete formula supplemented with whey protein. The PINI was calculated at baseline and on days 4,7,10,14, 21, and 28. The PINI decreased significantly from baseline (186 ± 202) to day 4 (116 ± 86) and reached a nadir at day 14 (27 ± 40). Serum CRP concentrations decreased significantly during the study period, while PA and ALB concentrations increased significantly. There was no change in the AAG concentration. Nitrogen balance increased significantly during the study period. The PINI was positively correlated with CRP concentration (r = 0.72, p = 0.0001) and negatively correlated with PA concentration (r = -0.56, p = 0.0004 and nitrogen balance (r = -0.51, p = 0.0018). The PINI decreased significantly during ENS of critically ill trauma patients, influenced primarily by a decrease in CRP concentration. Further studies are needed to characterize the PINI’s performance as a prognostic tool. Abbreviations: AAG = a,-acid glycoprotein, All = APACHE II score, ALB = albumin, ANOVA = analysis of variance, Cl = catabolic index, CRP = C-reactive protein, ENS = enteral nutritional support, HPI = hospital prognostic index, ISS = injury severity score, LSD = least significant difference, NB = nitrogen balance, NPC = nonprotein kilocalories, PA = prealbumin, PINI = prognostic inflammatory and nutritional index, PNI = prognostic nutritional index, TS = trauma score, UUN = urine urea nitrogen",
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