Related Experiment Video
Updated: Sep 9, 2025
Identification and Quantification of Deranged Metabolites in Critically Ill Patients Using NMR-Based Metabolomics
Published on: November 29, 2024
Association between prognostic nutritional index and all-cause mortality in critically ill patients with
Wenwen Ji1, Guangdong Wang1, Jia Liu2
1Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Background:
Ventilator-associated pneumonia (VAP) remains a significant clinical challenge in the ICU due to its high mortality rate. The Prognostic Nutritional Index (PNI), a composite biomarker based on serum albumin levels and total lymphocyte counts, reflects nutritional and immune status, but its prognostic significance in VAP patients remains unclear. This study evaluated the association between PNI and mortality in critically ill patients with VAP.
Methods:
We retrospectively analyzed data from 1,457 patients diagnosed with VAP from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Patients were grouped according to PNI quartiles and an identified optimal threshold. Cox regression, restricted cubic spline (RCS) analysis, and subgroup analyses were conducted to evaluate associations between PNI and 30-day and 90-day all-cause mortality.
Results:
Among 1,457 critically ill patients with VAP, the all-cause mortality rates were 23.68% at 30 days and 34.32% at 90 days. Patients in the highest PNI quartile exhibited significantly reduced mortality risks compared with the lowest quartile, with an adjusted HR of 0.60 (95% CI, 0.44-0.81) for 30-day mortality and 0.64 (95% CI: 0.50-0.82) for 90-day mortality. RCS analysis revealed a significant non-linear "L"-shaped relationship between PNI and mortality (p < 0.001). Below the threshold, patients with higher PNI had significantly lower risk of 30-day mortality (HR = 0.93, 95% CI: 0.91-0.95) and 90-day mortality (HR = 0.94, 95% CI: 0.92-0.96).
Conclusion:
A higher PNI at ICU admission was independently associated with lower short-term and long-term mortality in critically ill VAP patients. Routine assessment of PNI could enable early identification of high-risk patients and guide targeted nutritional and immunological interventions.
More Related Videos
Related Concept Videos
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:30Radiological Investigation II: MRI and Ventilation Perfusion Scan
Magnetic Resonance Imaging (MRI) and Ventilation Perfusion Scans are two radiological investigations that offer detailed diagnostic images of the body, particularly lung structures.
MRI
MRI uses magnetic fields and radiofrequency signals to distinguish between normal and abnormal tissues. This technology provides a more detailed diagnostic image than CT scans, enabling it to characterize pulmonary nodules, stage bronchogenic carcinoma, and evaluate inflammatory activity in...
01:30Pneumonia III: Complications and Assessment
01:29Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:19Factors Affecting Pulmonary Ventilation
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...