Prognostic Nutritional Index Predicts In-Hospital Mortality Among Patients with Clostridioides difficile Infection: A...

Area of Science:

• Infectious Diseases
• Clinical Biomarkers
• Geriatric Medicine

Background:

• Clostridioides difficile infection (CDI) is a significant cause of illness and death, especially in elderly hospitalized patients.
• Identifying reliable prognostic markers for CDI-related mortality is crucial for effective patient management.

Purpose of the Study:

• To evaluate the prognostic performance of routinely available inflammatory and nutritional biomarkers in predicting in-hospital mortality among CDI patients.
• To assess the independent association of the Prognostic Nutritional Index (PNI) with mortality in this population.

Main Methods:

• Retrospective observational study of 110 adult patients with confirmed CDI.
• Analysis of demographic, clinical, and laboratory data within 24 hours of admission.
• Assessment of neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), C-reactive protein-to-albumin ratio (CAR), and PNI using logistic regression and ROC curve analysis.

Main Results:

• In-hospital mortality rate was 20.0% (22/110 patients).
• Non-survivors had significantly higher NLR, dNLR, and CAR, and lower serum albumin and PNI compared to survivors.
• After multivariate adjustment, PNI remained independently associated with in-hospital mortality (p=0.018) and demonstrated good predictive performance.

Conclusions:

• The Prognostic Nutritional Index (PNI) is a simple, inexpensive, and readily available biomarker independently associated with in-hospital mortality in CDI.
• Immune-nutritional status plays a vital role in CDI outcomes.
• PNI shows potential utility for early risk stratification in hospitalized patients with CDI.