The prognostic nutritional index predicts all-cause mortality in extensively burned patients with sepsis.

Abstract

The aim of this study was to investigate the predictive value of the prognostic nutritional index (PNI) for 28-day mortality in extensively burned patients with sepsis. The clinical data of extensively burned patients with sepsis who were admitted to the First Affiliated Hospital of the Army Medical University from January 1, 2014, to December 31, 2021, were retrospectively analysed. Patients who lived were compared with those who died by independent-samples Mann-Whitney U test or chi-square test. Then the significantly different indicators between the two groups were subjected to multivariate regression analyses. A receiver operating characteristic (ROC) curve was drawn to obtain the corresponding cut-off value. Differences between the two groups of patients separated according to the cut-off value were analyzed. Kaplan-Meier survival analysis was performed. In total, 172 extensively burned patients with sepsis who met the inclusion criteria were included and divided into a survival group (n = 135 patients) and a nonsurvival group (n = 37 patients). Multivariate Cox regression analysis of the 28-day all-cause mortality of extensively burned patients with sepsis suggested that PNI was a protective factor for the outcomes of extensively burned patients with sepsis (P < 0.05). The calculated PNI cut-off value was 31.85. The survival rate of patients with a high PNI (≥31.85) was significantly higher than that of patients with a low PNI (<31.85). A low PNI is an independent risk factor for mortality in extensively burned patients with sepsis, and outperforms WBC and PLT. Timely and effective intervention treatments should be performed, when the PNI indicates a poor prognosis with the value less than 31.85.