Prognostic Nutritional Index as a Predictor of Mortality in Intensive Care Unit Patients with Pressure Injuries:...

Area of Science:

• Critical Care Medicine
• Nutritional Science
• Gerontology

Background:

• Pressure injuries (PIs) are common and serious complications in intensive care unit (ICU) patients.
• Assessing mortality risk in ICU patients with PIs is crucial for timely clinical decision-making.
• The Prognostic Nutritional Index (PNI) is a potential, yet understudied, biomarker for patient outcomes.

Purpose of the Study:

• To investigate the association between the Prognostic Nutritional Index (PNI) and mortality risk in intensive care unit (ICU) patients diagnosed with pressure injuries (PIs).
• To establish PNI as a potential tool for early risk stratification and clinical decision-making in this patient population.

Main Methods:

• Retrospective cohort study utilizing the Medical Information Mart for Intensive Care IV database.
• Included 972 ICU patients with diagnosed PIs, stratified by median PNI levels.
• Employed Kaplan-Meier analysis, Cox and logistic regression, restricted cubic splines, and propensity score matching (PSM) to analyze PNI's impact on 28-day, 90-day, and ICU mortality.

Main Results:

• A higher PNI was significantly associated with reduced 28-day (HR=0.702), 90-day (HR=0.722), and ICU mortality (OR=0.644).
• An L-shaped relationship was observed between PNI and all-cause mortality.
• The association remained significant after multivariate adjustment, subgroup analyses, and PSM.

Conclusions:

• The Prognostic Nutritional Index (PNI) is a valuable, accessible prognostic marker for ICU patients with pressure injuries (PIs).
• A PNI threshold below 19.02 identifies patients at increased mortality risk, guiding early nutritional and wound care interventions.
• This study is the first to demonstrate the prognostic significance of PNI in ICU patients with PIs.