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Prognostic Nutritional Index Enhances the Discriminatory Ability of Procalcitonin for Predicting Pediatric Sepsis
Deng Hongya1,2, Deng Linfan1,2, He Chunyuan1,2
1Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
Insights
The nutritional index (PNI) is linked to pediatric sepsis. Combining PNI with procalcitonin (PCT) improves sepsis prediction in children, aiding diagnosis and reducing mortality.
Area of Science:
- Pediatric critical care medicine
- Infectious diseases
- Biomarker research
Background:
- Pediatric sepsis diagnosis remains challenging, impacting mortality rates.
- Nutritional status can influence sepsis outcomes and progression.
- Biomarkers like procalcitonin (PCT) are established, but novel markers are needed.
Purpose of the Study:
- To evaluate the diagnostic discriminatory capacity of the nutritional index (PNI) in pediatric sepsis.
- To compare the predictive significance of PNI, PCT, and their combination for pediatric sepsis.
- To assess if PNI improves the predictive power of PCT in diagnosing pediatric sepsis.
Main Methods:
- Retrospective enrollment of 134 children with suspected sepsis.
- Collection of clinical and laboratory data, including PNI and PCT levels.
- Analysis using Receiver Operating Characteristic (ROC) curves, Decision Curve Analysis (DCA), and Net Reclassification Improvement (NRI).
Main Results:
- Of 134 patients, 65 were diagnosed with sepsis and 69 with non-sepsis.
- Both PCT and PNI showed independent association with pediatric sepsis.
- PCT demonstrated superior predictive ability compared to PNI alone.
- A combined model (PCT + PNI) significantly enhanced predictive capacity over individual markers.
Conclusions:
- PNI is independently associated with pediatric sepsis in children.
- Incorporating PNI into PCT-based models improves the diagnostic prediction of pediatric sepsis.
- This combined approach offers potential for enhanced early sepsis detection in pediatric patients.
Abstract:
Objective. Improving diagnostic ability of pediatric sepsis is of great significance for reducing the mortality of sepsis. This study explored the discriminatory capacity of nutritional index (PNI) in pediatric sepsis. Methods. We retrospectively enrolled 134 children with suspected sepsis and collected their clinical and laboratory data. Receiver operating characteristic curves (ROC), decision curve analysis (DCA) and net reclassification improvement (NRI) were performed to compare the predictive significance of the PNI, procalcitonin (PCT) and their combination. Results. Among 134 patients, 65 children were diagnosed with sepsis and 69 children with non-sepsis. PCT and PNI were independently associated with pediatric sepsis. PCT was superior to PNI to predict pediatric sepsis. The model based on PCT + PNI improved the predictive capacity than them alone, as demonstrated by ROC, DCA and NRI, respectively. Conclusion. PNI was independently associated with pediatric sepsis, and addition of PNI could improve the capacity of PCT to predict pediatric sepsis.
