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Prognostic value of pretreatment prognostic nutritional index in intravenous immunoglobulin-resistant Kawasaki disease

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Abstract

The aim of the present study was to investigate the potential predictive significance of pretreatment prognostic nutritional index (PNI) in intravenous immunoglobulin (IVIG) resistant Kawasaki disease (KD). The PNI, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were analyzed in 1257 eligible patients with KD. Receiver operating curve analysis was used to explore the prediction accuracy for IVIG-resistant KD. The optimal cut-off values were identified as 49.5 for PNI, 3.58 for NLR and 164.00 for PLR, respectively. Lower pretreatment PNI (< 49.5) was demonstrated to be associated with lower age, serum sodium levels and platelet counts, and with a higher incidence of IVIG resistance and higher C-reactive protein levels. There was a significantly negative association between the PNI and NLR, and PLR. Univariate and multivariate analyses revealed that PNI, NLR and PLR were independent predictive factors for IVIG resistance. The discriminatory ability of PNI was not inferior to NLR, PLR and their combination (NLR > 3.58 and PLR > 164) for predicting IVIG resistance, respectively. Pretreatment PNI may serve as a novel surrogate independent predictor for IVIG-resistant KD.

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Acknowledgements

We acknowledge for their contribution Ju Zeng (The First People's Hospital of Yibin, SiChuan, China), Zhengxia Han (The Second People's Hospital of Yibin, SiChuan, China), Guoguang Jian (Luzhou people's Hospital, SiChuan, China) and Zhiling Ran (Southwest Medical University Affiliated Hospital of traditional Chinese Medicine, SiChuan, China).

Funding

This work was supported by Foundation of Southwest Medical University (NO. 2017-ZRQN-061 and NO. 2017-ZRQN-120).

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Author notes

  1. Gang Li and Xiumei Xu contributed equally to this work.

Authors and Affiliations

  1. Department of Pediatrics, the Affiliated Hospital of Southwest Medical University, No. 8, Section 2, Kangcheng Road, Jiangyang District, Luzhou, Sichuan, China

    Gang Li, Xiumei Xu & Bin Liu

  2. Sichuan Clinical Research Center for Birth Defects, Luzhou, Sichuan, China

    Gang Li, Xiumei Xu & Bin Liu

  3. Department of Pediatrics, Sichuan Academy of Medical Sciences, Sichuan People’s Hospital, No. 32, Section 2, 1st Ring Rd, Chengdu, Sichuan, China

    Pengyuan Chen

  4. Neonatal Department, Dujiangyan Medical Center, Chengdu, Sichuan, China

    Rumeng Zeng

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  1. Gang Li
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Contributions

GL and XX conceived of and designed this study, designed the data collection instrument, joined the consensus conference, drafted the initial manuscript, and reviewed and revised the manuscript, approved the final manuscript as submitted and agree to be accountable for all aspects of the work. PC participated in the data collection. RZ participated in the consensus conference, critically reviewed the manuscript for important intellectual content, approved the final manuscript as submitted and agreed to be accountable for all aspects of the work. BL analyzed the data and drafted the initial manuscript. All authors reviewed the manuscript.

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Correspondence to Gang Li.

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Li, G., Xu, X., Chen, P. et al. Prognostic value of pretreatment prognostic nutritional index in intravenous immunoglobulin-resistant Kawasaki disease. Heart Vessels 36, 1366–1373 (2021). https://doi.org/10.1007/s00380-021-01819-w

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  • DOI: https://doi.org/10.1007/s00380-021-01819-w

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