Relationship Between the Prognostic Nutritional index and Short-Term Prognosis among Patients with Community-Acquired Bacterial Pneumonia: A Retrospective Analysis of the MIMIC-IV

Abstract

Objectives

The objective of this study was to investigate the association between the prognostic nutritional index (PNI) and the short-term outcomes in patients with community-acquired bacterial pneumonia (CABP).

Design

This study employed a retrospective design, utilizing data from the Medical Information Mart for Intensive Care (MIMIC)-IV database.

Participants

371 individuals from the MIMIC-IV database who were diagnosed with CABP.

Primary and secondary outcomes

The primary endpoint was 28-day all-cause mortality. The secondary endpoint was the length of stay (LOS) in the intensive care unit (ICU) and in hospital.

Results

The area under the curve of PNI for predicting 28-day all-cause mortality is 0.702 (95% CI 0.630 to 0.775; p < 0.001). Patients were divided into two groups based on their PNI at admission: the low PNI (<35.75) group and the high PNI group (≥35.75). CABP patients with higher PNI presented a lower 28-day all-cause mortality rate (adjusted HR: 0.53, 95% CI 0.28-0.98, p = 0.044). Moreover, a negative linear correlation was found between the PNI and short-term mortality rates via restricted cubic splines. Eventually, there was no difference in the LOS in the ICU or hospital between the two groups.

Conclusion

These findings suggest a negative correlation between the PNI at admission and the short-term mortality rate of CABP. PNI is helpful for early identification of high-risk patients.