Performance Of The Prognostic Nutritional Index In Predicting 28-day Mortality In Patients With Sepsis

Objective:The Prognostic Nutritional Index(PNI)is a screening tool for immunonutritional-related risk that correlates with mortality and post-operative complications in various malignancies.The aim of this study was to investigate whether PNI was associated with 28-day mortality in patients with sepsis.Methods:This study reviewed medical records of 211 patients who underwent sepsis or septic shock in an emergency department.The PNI was calculated as serum albumin(g/L)+5×total lymphocyte count×10~9/L.The receiver operating characteristic(ROC)curve analysis was performed to determine the cut-off value of the PNI,which was set at 35.14.Patients with a PNI?35.14 or<35.14 were assigned a PNI score of 0 or 1,respectively.Univariate and multivariate analysis were performed to assess the prognostic factors.Results:89 patients(42.2%)died within 28 days.The PNI=1 group was significantly associated with hemoglobin,platelet,procalcitonin and septic shock(p<0.05).Multivariate analysis showed that PNI(1 vs.0,OR,4.428;995%CI,2.434-8.057;P<0.001)was a significant independent predictor of 28-day mortality in patients with sepsis and septic shock.Moreover,cumulative survival was significantly lower for patients with a PNI of 1compared to patients with a PNI of 0(Log-Rank=41.4,P<0.001).Conclusions:The PNI,calculated based on the serum albumin level and total lymphocyte count,is a prognostic factor for short-term mortality in patients with sepsis.Patients with a PNI below 35 may face an immunonutritional-related risk.