Prognostic nutritional index: A potential biomarker for predicting the prognosis of decompensated liver cirrhosis

Abstract

BackgroundPrognostic nutritional index (PNI) is an independent predictor of the prognosis of various diseases. However, the prognosis value of PNI in patients with decompensated liver cirrhosis (DLC) remains unknown. The study aimed to investigate the prognostic significance of PNI in patients with DLC.MethodsA total of 214 eligible patients were enrolled in the study’s development cohort between January 2018 and March 2021. The clinical primary study endpoints were mortality at 3 and 6 months. Receiver operating characteristic (ROC) curve analysis was used to assess the PNI’s prediction accuracy, and Youden’s index was utilized to determine the PNI’s optimal cut-off value. Moreover, based on the optimal cut-off value, patients were categorized into high and low PNI groups. Multivariate logistic regression analysis was used to determine independent risk factors for mortality, while the relationship between PNI and the risk of death was identified and demonstrated using restricted cubic splines (RCS). A validation cohort of 139 patients was to verify the predictive power of the PNI.ResultsIn the development cohort, the mortality rate at 3 and 6 months were 10.3% (22) and 14.0% (30), respectively. The PNI had comparable predictive power with the MELD score at all follow-up endpoints. Decreased PNI was an independent predictor of adverse prognosis at all follow-up endpoints. The RCS revealed a linear correlation between PNI and the risk of death. We confirmed that lower PNI was an independent predictor of poor prognosis in the validation cohort.ConclusionThe findings showed that lower PNI is an independent factor of poor outcomes and might be utilized as a potentially promising prognostic predictor in patients with DLC.

Inflammatory Indices for Overall Survival in Hemodialysis Patients: A multicenter cohort study

“…In recent years, the utility of PNI as a prognostic indicator for overall survival has been validated in patients with cancer, cardiovascular disease, decompensated liver cirrhosis, diabetic nephropathy and those undergoing dialysis [22][23][24][25]. Consistent with previous studies, our RCS model revealed a linear-like relationship between PNI and all-cause mortality of hemodialysis patients, with a smooth curve that closely resembled a straight line, indicating a strong prognostic value of PNI.…”

Prognostic Nutritional Index Correlates with Liver Function and Prognosis in Chronic Liver Disease Patients

“…Currently, there are many challenges with tools used to assess the nutritional status of CLD patients. PNI is a simple, objective indicator of inflammation and nutritional status, calculated from only serum albumin and lymphocyte counts [ 15 , 16 , 31 ]. In recent studies, PNI has also been significantly correlated with prognosis and nutritional status in a variety of diseases [ 31 ].…”

“…PNI is a simple, objective indicator of inflammation and nutritional status, calculated from only serum albumin and lymphocyte counts [ 15 , 16 , 31 ]. In recent studies, PNI has also been significantly correlated with prognosis and nutritional status in a variety of diseases [ 31 ]. PNI may be useful in the nutritional assessment of patients with CLD.…”

Association between the prognostic nutritional index (PNI) and all-cause mortality in patients with chronic kidney disease

“…The PNI is a systemic immunonutrition index based on peripheral lymphocyte counts and serum albumin levels [ 21 ], which provides a reliable and comprehensive assessment of the nutritional and inflammatory status of patients [ 22–23 ]. In addition, the PNI has been shown to be a prognostic biomarker for all-cause mortality in patients with decompensated liver cirrhosis [ 24 ], type-2 diabetes [ 25 ] and various cancers [ 26–29 ]. The PNI is also a predictor of the progression of diabetic nephropathy, and PNI is inversely associated with the incidence of end-stage nephropathy [ 30 ].…”