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

The study aimed at evaluating the prognostic utility of the prognostic nutritional index (PNI) for patients with sepsis.

Data in the present study were obtained from the Multiparameter Intelligent Monitoring in Intensive Care Database III. The calculation for PNI was as follows: serum albumin concentration (g/L) +0.005 × total lymphocyte count. 30-day mortality was considered as the primary outcome, while 90-day mortality and one-year mortality were the secondary outcomes. Cox proportional risk models and propensity score matching (PSM) analyses were used to analyze the association between PNI and clinical outcomes in patients with sepsis. To assess the predictive value of PNI for 30-day mortality, receiver operator characteristic (ROC) curve analysis was performed.

A total of 2669 patients were in the study. After the confounding factors were adjusted, PNI ≥ 29.3 was identified as an independent predictive prognostic factor for the 30-day all-cause mortality (hazard ratio [HR]: 0.65; 95% confidence interval [CI]: 0.56-0.76; p < 0.00001). Moreover, PSM analysis further validated the prognostic predictive value of PNI for patients with sepsis. The AUC of the PNI was 0.6436 (95% CI: 0.6204-0.6625) which was significantly high than the AUC of NLR (0.5962, 95% CI: 0.5717-0.6206) (p = 0.0031), the RDW (0.5878, 95% CI: 0.5629-0.6127) (p < 0.0001), and PLR (0.4979, 95% CI: 0.4722-0.5235) (p < 0.0001).

The findings suggested that PNI was also a significant risk factor for sepsis.