Prognostic nutrition index is associated with the all‐cause mortality in sepsis patients: A retrospective cohort study

Wu, Huizi; Zhou, Chong‐Jun; Kong, Wanquan; Zhang, Yi; Pan, Da

doi:10.1002/jcla.24297

Cited by 21 publications

(17 citation statements)

References 44 publications

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“…As a combined biomarker of lymphocytes and albumin, PNI is simple, efficient, and easy to obtain [ 15 ]. In addition, PNI can reflect the severity of inflammation and the nutritional status of the disease at the same time.…”

Section: Discussionmentioning

confidence: 99%

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Clinical Value of the Prognostic Nutrition Index in the Assessment of Prognosis in Critically Ill Patients with Stroke: A Retrospective Analysis

Liu

Yang

Kadasah

et al. 2022

Computational and Mathematical Methods in Medicine

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Purpose. The purpose of study was to evaluate the association between prognostic nutritional index (PNI) and all-cause mortality of critically ill patients with stroke. Methods. Clinical data derived from Multiparameter Intelligent Monitoring in Intensive Care were analyzed. The primary endpoint was 30-day all-cause mortality; secondary endpoints were 90-day mortality and one-year cause mortality. The potential prognostic roles of PNI were analyzed by Cox proportional hazard models. The independent prognostic roles of PNI in the cases were analyzed by smooth curve fitting. Results. Concerning 30-day mortality, the HR (95% CI) for a high PNI (≥39.7) was 0.700 (0.544, 0.900; P = 0.00539 ), compared to a low PNI (<39.7). After adjusting for multiple confounders, the HR (95% CI) for a high PNI (≥39.7) was 0.732 (0.547, 0.978; P = 0.03514 ), compared to a low PNI (<39.7). Regarding 90-day and one-year mortality, a similar trend was observed. In addition, a nonlinear association between PNI and 30-day mortality was found. Using recursive algorithm and two-piecewise linear regression model, inflection point (IP) was calculated, which was 49.4. On the right side of the IP, there was a positive relationship between PNI and 30-day mortality, and the effect size, 95% CI, and P value were 1.04 (1.01, 1.07), P = 0.0429 , respectively. On the left of the IP, the effect size, 95% CI, and P value were 0.97 (0.96, 0.99) and 0.0011, respectively. Conclusions. The PNI was an independent predicting factor of 30-day, 90-day, and 1-year mortality of the critically ill patients with stroke. In addition, there was a U-shaped relationship between PNI and all-cause mortality of stroke patients. PNI was a risk factor for the outcome of stroke when PNI was >49.4, while PNI was a protective factor for outcome of stroke when PNI was <49.4.

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Section: Discussionmentioning

confidence: 99%

“…Recent evidence showed that PNI was closely associated with clinical outcomes of cancer [ 13 , 14 ] and sepsis [ 15 , 16 ]. However, the prognostic role of PNI in the cases with stroke is still unclear.…”

Section: Introductionmentioning

confidence: 99%

Clinical Value of the Prognostic Nutrition Index in the Assessment of Prognosis in Critically Ill Patients with Stroke: A Retrospective Analysis

Liu

Yang

Kadasah

et al. 2022

Computational and Mathematical Methods in Medicine

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“…It could cause the deficiencies in some nutrients including minerals and vitamins, which also leads to the variations in RDW levels. 34 The strength of our research was that RDW could be a simple predictor for risk stratification of patients with septic shock based on large samples. Checking RDW on admission as early as possible and identifying its elevation as a risk factor of poor prognosis could be uti-…”

Section: Discussionmentioning

confidence: 95%

“…Additionally, malnutrition may occur in some septic shock patients due to gastroenterological dysfunction. It could cause the deficiencies in some nutrients including minerals and vitamins, which also leads to the variations in RDW levels 34 …”

Section: Discussionmentioning

confidence: 99%

Red cell distribution width and in‐hospital mortality in septic shock: A public database research

Ding

et al. 2022

Int J Lab Hematology

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Objective: This study aimed to explore the relationship between red cell distribution width (RDW) and in-hospital mortality in septic shock based on a large-scale public database.Methods: All patients with septic shock in MIMIC-IV were enrolled. Based on RDW values, the general characteristics of different groups were compared. Different models were constructed for exploring the association of RDW and in-hospital mortality. To assess the predictive value of RDW, receiver operator characteristic (ROC) curve analysis was applied.Results: A total of 3006 patients with septic shock were included and in-hospital mortality was 32.27% (n = 970). The results of the fully adjusted model demonstrated that RDW was positively associated with in-hospital mortality in septic shock patients after adjusting all confounders (OR = 1.12, 95% CI:1.08-1.17, p < .001). A linear relationship between RDW and in-hospital mortality was found. For predicting in-hospital mortality, the area under the ROC curve (AUC) of RDW was .602 and the best threshold of RDW was 17.25%. Conclusion:RDW was associated with in-hospital mortality in septic shock. It could be a useful marker for predicting clinical outcomes in septic shock.

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“…PNI was developed to assess the preoperative nutritional immune status and postoperative complications in surgical patients and has since been demonstrated to be a reliable prognostic factor for numerous malignancies, such as gastric cancer [ 16 ], intrahepatic cholangiocarcinoma [ 29 ], esophageal cancer [ 30 ], and nasopharyngeal carcinoma [ 31 ]. In the field of sepsis, Wu et al reported that after adjusting for confounding variables, PNI was asserted to be an independent prognostic factor for all-cause mortality at 30 days [ 32 ]. Additional studies have concluded that the presence and severity of neonatal sepsis were negatively and independently associated with PNI.…”

Section: Discussionmentioning

confidence: 99%

Clinical Value of Prognostic Nutritional Index and Neutrophil-to-Lymphocyte Ratio in Prediction of the Development of Sepsis-Induced Kidney Injury

et al. 2022

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Background. Sepsis-related acute kidney injury (S-AKI) is a frequent complication of hospitalized patients and is linked to increased morbidity and mortality. Early prediction and detection remain conducive to optimizing treatment strategies and limiting further insults. This study was aimed at evaluating the potential predictive value of the combined prognostic nutrition index (PNI) and neutrophil-to-lymphocyte ratio (NLR) to predict the risk of AKI in septic patients. Methods. In this retrospective study, 1238 adult patients with sepsis who were admitted to the First Affiliated Hospital of Xi’an Jiaotong University from January 2015 to June 2021 were enrolled. Patients were divided into two groups: the non-AKI group ( n = 731 ) and the S-AKI group ( n = 507 ). Univariate and multivariate logistic regression analyses were performed to screen the independent predictive factors of S-AKI. A receiver operating characteristic (ROC) curve was used to evaluate the predictive value of PNI and NLR. Results. Multivariate logistic regression analysis indicated that age, chronic liver disease, cardiovascular disease, respiratory rate (RR), white blood cells (WBC), blood urea nitrogen (BUN), creatinine (CRE), international normalized ratio (INR), neutrophil-to-lymphocyte ratio (NLR), and prognostic nutrition index (PNI) were independent prognostic factors of S-AKI. In the three models, the adjusted OR of PNI for S-AKI was 0.802 (0.776-0.829), 0.801 (0.775-0.829), and 0.717 (0.666-0.772), while that of NLR was 1.094 (1.078-1.111), 1.097 (1.080-1.114), and 1.044 (1.016-1.072), respectively. In addition, the area under the ROC curve of the PNI plus NLR group was significantly greater than that of the CRE plus BUN group (0.801, 95% CI: 0.775-0.827 vs. 0.750, 95% CI: 0.722-0.778, respectively; P < 0.001 ). Conclusions. PNI and NLR have been identified as readily available and independent predictors in septic patients with S-AKI. PNI, in combination with NLR, is of vital significance for early warning and efficient intervention of S-AKI and is superior to combined BUN and CRE.

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Prognostic nutrition index is associated with the all‐cause mortality in sepsis patients: A retrospective cohort study

Cited by 21 publications

References 44 publications

Clinical Value of the Prognostic Nutrition Index in the Assessment of Prognosis in Critically Ill Patients with Stroke: A Retrospective Analysis

Clinical Value of the Prognostic Nutrition Index in the Assessment of Prognosis in Critically Ill Patients with Stroke: A Retrospective Analysis

Red cell distribution width and in‐hospital mortality in septic shock: A public database research

Clinical Value of Prognostic Nutritional Index and Neutrophil-to-Lymphocyte Ratio in Prediction of the Development of Sepsis-Induced Kidney Injury

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