ObjectiveTo evaluate whether three preoperative nutritional scoring indices, the Naples prognostic score (NPS), controlling nutritional status (CONUT), and prognostic nutritional index (PNI), are associated with the clinicopathological characteristics and prognosis of patients with esophageal squamous cell carcinoma (ESCC). MethodsA retrospective analysis was conducted on clinical data from ESCC patients who underwent surgical treatment in the Department of Thoracic Surgery at the First Hospital Affiliated to the University of Science and Technology of China between 2017 and 2019. Based on NPS, CONUT, and PNI scores, optimal cutoff values were determined using X-tile software to divide patients into a high-value group and a low-value group. Differences in clinicopathological characteristics between groups were compared. Survival analysis was performed using Kaplan-Meier method and log-rank test. Multivariate Cox proportional hazards model was used to analyze factors influencing overall survival (OS). The predictive performance of each nutritional index was evaluated by area under receiver operating characteristic curve (AUC). Differences in AUC values among ROC curves were compared using MedCalc software. ResultsA total of 606 ESCC patients were included, comprising 459 males and 147 females, with a mean age of (65.98±7.60) years. Univariate analysis showed that age, squamous cell carcinoma antigen level, NPS, CONUT, PNI, TNM stage, degree of differentiation, and tumor size were all risk factors affecting OS in ESCC patients (P<0.05). Multivariate analysis revealed that age, TNM stage, and NPS were independent risk factors for OS. Among the indices analyzed for prognostic efficacy via AUC values comparison, NPS demonstrated the highest AUC value (0.681) with statistically significant superiority over PNI and CONUT (P<0.05). Conclusion Age, TNM stage, and NPS are independent risk factors affecting the OS of ESCC patients after surgery. Moreover, prognostic evaluation efficacy of NPS surpasses that of PNI and CONUT, indicating its potential as a significant indicator for predicting outcomes in ESCC patients.
ObjectiveTo investigate the prognostic value of the ratio of tricuspid annular plane systolic excursion to pulmonary artery systolic pressure (TAPSE/PASP) for all-cause mortality after left ventricular assist device (LVAD) implantation, and to provide evidence for optimizing preoperative risk stratification and perioperative management in LVAD patients. MethodsClinical data were retrospectively collected from patients undergoing LVAD implantation at Zhengzhou 7th People's Hospital between April 21, 2021, and August 24, 2025. The optimal cutoff value of TAPSE/PASP was determined using receiver operating characteristic (ROC) curve analysis, and patients were grouped accordingly. Kaplan-Meier curves were used to compare postoperative cumulative survival rates between groups. Multivariate Cox proportional hazards regression models were applied to identify independent predictors of all-cause mortality. ResultsA total of 61 patients were enrolled, including 44 males and 17 females with a median age of 56 (42, 60) years. Patients were divided into a group A (TAPSE/PASP<0.396, n=43) and a group B (TAPSE/PASP≥0.396, n=18) based on the optimal cutoff value of 0.396. Group A exhibited higher median right ventricular fractional area change (40% vs. 33%, P<0.001), ratio of right ventricular fractional area change to PASP (1.214 vs. 0.615, P<0.001), and preoperative left ventricular end-diastolic diameter (77 mm vs. 69 mm, P=0.006). Conversely, group A showed lower TAPSE/PASP ratio (0.333 vs. 0.508, P<0.001), PASP (34 mm Hg vs. 52 mm Hg, P<0.001), diastolic pulmonary artery pressure (13 mm Hg vs. 29 mm Hg, P<0.001), mean pulmonary artery pressure (21 mm Hg vs. 34 mm Hg, P=0.001), and preoperative central venous pressure (5.5 mm Hg vs. 11.0 mm Hg, P=0.002). Additionally, group A had higher incidence of tricuspid valve repair/replacement (55.8% vs. 27.8%, P=0.046) and shorter median survival time (96 days vs. 212 days, P=0.007). Median follow-up duration was 157 (56, 227) days. Log-rank analysis demonstrated significantly lower survival rate in the group A compared to group B (P=0.009). Multivariate Cox regression analysis identified TAPSE/PASP as an independent predictor for all-cause mortality after LVAD implantation [HR=0.001, 95%CI (0.001, 0.003), P=0.005]. The ROC curve demonstrated an area under the curve of 0.740 for TAPSE/PASP in predicting postoperative all-cause mortality. ConclusionTAPSE/PASP effectively evaluates right ventricular-pulmonary artery coupling status and serves as an independent prognostic factor for all-cause mortality following LVAD implantation. This parameter provides important guidance for preoperative risk assessment and perioperative management in LVAD candidates.
