The correlation between prognostic nutritional index and the prognosis of patients with severe liver cirrhosis:analyses based on the MIMIC database
Objective:To explore the correlation between prognostic nutritional index(PNI)and the prognosis of patients with severe liver cirrhosis.Methods:Retrospectively collected critically ill patients with liver cirrhosis from the Medical Information Mart for Intensive Care(MIMIC-IV)database,version 2.0,covering the years 2008 to 2019.Based on the 90-day prognosis,patients were divided into survival and death groups,and the differences in baseline characteristics were compared.Using restricted cubic spline(RCS)analysis,the PNI value at which the hazard ratio(HR)for90-day prognosis was1 was identified,and patients were categorized into high PNI(≥34.46)and low PNI(<34.46)groups.Kaplan-Meier method was used to plot cumulative survival curves for the two groups of patients with liver cirrhosis at 90 days,and a Cox regression model was established to analyze the correlation between PNI and the 90-day prognosis.Results:The PNI value was significantly lower in the death group(P<0.05).RCS analysis showed a nonlinear trend between PNI and the risk of 90-day all-cause mortality(P<0.001).Within a certain range,as the PNI value decreased,the risk of 90-day all-cause mortality in critically ill patients with liver cirrhosis increased.Survival analysis showed that compared to the high PNI group,the cumulative survival rate at 90 days was significantly lower in the low PNI group(P<0.001).Multivariate Cox regression analysis indicated that low PNI was an independent risk factor for 90-day all-cause mortality in patients with severe liver cirrhosis(P<0.05).Conclusion:A decreased PNI level(<34.46)upon ICU admission was an independent risk factor for 90-day all-cause mortality in patients with severe liver cirrhosis.This highlighted the practicality of the PNI as a predictive tool in risk stratification for patient prognosis.
NETL
NSTL
万方数据
维普
