The cancer anorexia-cachexia syndrome: a survey of the Prognostic Inflammatory and Nutritional Index (PINI) in advanced disease.

Other than weight loss, most traditional methods of nutritional assessment are not acceptable in advanced cancer patients because they are inaccurate, too expensive for routine use, or too difficult for a debilitated person to complete. The prognostic inflammatory and nutritional index (PINI) is a formula devised to evaluate nutritional status and prognosis in critically ill patients. It has been suggested that the PINI score can be used to follow most pathological conditions. It has been measured in several settings and has been found to be a reliable indicator of both nutritional status and prognosis in trauma, burn, infected, and cardiac patients. In this pilot study, we evaluated the PINI in 50 consecutive patients referred to a palliative care service. Compared to a value in normal, healthy people of <1, the mean score in this sample was 102 (SD = 142, 95% CI = 62-142). The mean protein values were: alpha-1-acid glycoprotein 1409 mg/l (SD = 556, 95% CI = 1251-1567); C-reactive protein (CRP) 106 mg/l (SD = 89, 95% CI = 81-131); albumin 24 g/l (SD = 7, 95% CI = 23-26); and prealbumin 147 mg/l (SD = 73, 95% CI = 126-168). There was no significant association between the PINI and corticosteroid use, weight loss over time, age, or sex. These data indicate that the PINI is highly abnormal in our population. The CRP may be the most important value.