Predictive Value of Onodera’s Prognostic Nutritional Index for Short-Term Mortality in Subjects with Acute Pulmonary Embolism

• Published in: Istanbul medical journal Vol. 26; no. 2; pp. 129 - 134
• Main Authors: Karaca, Mehmet, Taşlıçukur, Şölen, Yüksel, Gizem, Tanyolaç, Selim, Özkan, Fatih, Karabağ, Turgut, Öz, Ahmet
• Format: Journal Article
• Language: English
• Published: Galenos Yayinevi Tic. Ltd 01.05.2025; Galenos Yayinevi
• Subjects: onodera’s prognostic nutrition index; pulmonary embolism; pulmonary embolism severity index; short-term mortality
• ISSN: 1304-8503; 2619-9793; 2148-094X
• DOI: 10.4274/imj.galenos.2025.14603

Introduction: The Pulmonary Embolism Severity Index (PESI) is a widely used tool for assessing prognosis and predicting 30-day mortality in acute pulmonary embolism (APE) patients. Onodera’s Prognostic Nutrition Index (OPNI) is a simple tool that provides information on the nutritional status and prognosis of subjects, especially in gastrointestinal system malignancies. This academic work aims to evaluate the relationship between the OPNI score, which is a simple risk stratification tool, and the PESI score, short-term mortality (STM) in subjects diagnosed with pulmonary embolism (PE). Methods: A total of 176 PE subjects were included in this retrospective academic work. The PESI scores and OPNI scores of all subjects were calculated using the formula serum albumin (g/L) + 0.005 × total lymphocyte count (cells/mm3). The primary outcome of the academic work was accepted as the in-hospital mortality along with STM rate within 30 days from the time of diagnosis. Results: The mean age of all subjects, PESI score, and OPNI score were 62.93±16.57, 98.83±39.35, and 42.86±8.06, respectively. There was a considerable inverse relationship between PESI score and OPNI (r=-0.401, p<0.001). In multivariate analysis, OPNI value [odds ratio (OR): 0.89, 95% confidence interval (CI): 0.83-0.96; p=0.002), cancer history (OR: 3.62, 95% CI: 1.30-10.10; p=0.014), oxygen saturation (OR: 0.86, 95% CI: 0.80-0.93; p<0.001) and male sex (OR: 2.73, 95% CI: 1.02-7.34; p=0.047) were found to be independent predictors of STM. The optimal OPNI cut-off value for predicting STM, based receiver operating characteristic curve analysis was ≤39.17, yielding a sensitivity of 75.5% and specificity of 67.6%. Conclusion: OPNI appears to be a promising, easily applicable, operator-independent and cost-effective parameter for predicting STM in subjects with APE.