Measurement and comparison of serum proteins can help discriminate between metabolic stress and nutritional deprivation.
(1) alpha-1 acid glycoprotein in mg/L
(2) C-reactive protein (CRP) in mg/L
(3) serum albumin in g/L
(4) transthyretin in mg/L
prognostic inflammatory and nutrition index (PINI) =
= ((alpha-1 acid glycoprotein in mg/L) * (C-reactive protein in mg/L)) / ((albumin in g/L) * (transthyretin in mg/L))
• Transthyretin is also called pre-albumin or thyroxine-binding pre-albumin
alpha-1 acid glycoprotein
550 - 1,400 mg/L
0.2 - 6.1 mg/L
35 - 50 g/L
100 - 400 mg/L
• The higher the score the greater the risk of malnutrition.
Risk of Malnutrition
well-nourished without infection (no risk)
1 - 10
11 - 20
21 - 30
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Purpose: To distinguish between metabolic stress and nutritional deprivation using the Prognostic Inflammatory and Nutrition Index (PINI).
Objective: severity, prognosis, stage, differential diagnosis and mimics, red flags
ICD-10: E43, E44,