Prognostic nutritional index: Is it associated with the prognosis of Crimean Congo hemorrhagic fever

Abstract

Introduction The prognostic nutritional index (PNI) is calculated using total serum lymphocyte counts and albumin levels. We aimed to analyze the role of PNI in predicting intensive care unit (ICU) referral and mortality in patients with Crimean Congo hemorrhagic fever (CCHF). Materials and Methods Our target population was adult (age >18) patients who presented between March 2015 and October 2021 within 5 days of symptom emergence and were diagnosed with CCHF. The predictive value of PNI was analyzed by the receiver operating curve analysis. The patients were categorized based on the severity grading scores (SGS) as mild, moderate, and severe. The relationship between PNI and ICU referral and mortality was analyzed by logistic regression analysis. Results Overall, 115 patients with the diagnosis of CCHF were included. 13.9% (n = 16) of the patients were referred to ICU while 11.3% (n = 13) died. A comparison of the patients with different SGS grades revealed that they were significantly different regarding PNI (p < 0.001). There was a significant negative correlation between PNI and SGS (r = −0.662; p < 0.001). PNI had a PV regarding ICU referral and mortality ([area under the curve [AUC] = 0.723, 95% confidence interval [CI]: 0.609–0.836, p = 0.004 [AUC = 0.738, 95% CI: 0.613–0.863, p = 0.005]). The PNI threshold was 36.1 for ICU referral and mortality. The rates of female patients, hospitalization periods longer than 1 week, platelet apheresis replacement, diabetes mellitus, bleeding history, ICU admission, and mortality were significantly higher in patients with a PNI of lower than 36.1 (p < 0.05). Conclusion PNI can predict ICU referral and mortality in patients admitted due to CCHF.

Relationship between Prognostic Nutritional Index and Amputation in Patients with Diabetic Foot Ulcer

“…In our study, although there was no statistical difference between the amputee and non-amputee groups, the lymphocyte count was lower in the amputee group. Similar to our study, in studies evaluating the relationship between PNI and mortality in infective endocarditis and Crimean-Congo hemorrhagic fever, PNI was found to be significant, although there was no significant difference in lymphocyte count between the groups [8,21]. In the PNI formula, lower lymphocyte counts contribute to a lower PNI score, indicating potential immune system compromise.…”

Gram-Negative Bloodstream Infections in Healthcare: The Relationship Between Antibiotic Resistance, Mortality, and Novel Serological Biomarker

“…In a previous study, PNI was associated with mortality in COVID-19 infection [ 17 ]. In another study, a decrease in PNI was found to be associated with the exitus rate in Crimean-Congo hemorrhagic fever [ 18 ]. This study investigated the relationship between PNI and mortality in Gram-negative bacterial infections, showing a negative correlation similar to viral infections.…”

Association between the prognostic nutritional index (PNI) and all-cause mortality in patients with chronic kidney disease

“…Initially, the PNI was used to assess preoperative nutritional status, surgical risk and postoperative complications in surgical patients [ 11 ]. However, a lower PNI was also reported to be associated with an increased risk of death in several conditions, including severe stroke [ 12 ], diabetic foot ulcers [ 13 ], Crimean-Congo hemorrhagic fever [ 14 ], heart failure [ 15 ] and CKD in elderly patients [ 16 ]. However, there is currently no evidence that the PNI is associated with all-cause mortality in patients with CKD.…”