Association between prognostic nutritional index and all-cause mortality among intestinal obstruction patients in the intensive care unit: a retrospective study
BackgroundIntestinal obstruction (IO) is a common surgical emergency associated with significant morbidity and mortality, particularly in critically ill ICU patients. The Prognostic Nutritional Index (PNI), calculated using serum albumin levels and total lymphocyte counts, has demonstrated prognosti...
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Frontiers Media S.A.
2025-06-01
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| Series: | Frontiers in Nutrition |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2025.1583201/full |
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| author | Yuanshuo Ge Yuanshuo Ge Zhe Wang Cheng Zhang |
| author_facet | Yuanshuo Ge Yuanshuo Ge Zhe Wang Cheng Zhang |
| author_sort | Yuanshuo Ge |
| collection | DOAJ |
| description | BackgroundIntestinal obstruction (IO) is a common surgical emergency associated with significant morbidity and mortality, particularly in critically ill ICU patients. The Prognostic Nutritional Index (PNI), calculated using serum albumin levels and total lymphocyte counts, has demonstrated prognostic value in various conditions. However, its role in critically ill IO patients remains unexplored.MethodsWe conducted a retrospective cohort study using the MIMIC-IV database. Critically ill patients with IO were identified, and their PNI values on the first day of ICU admission were recorded. Patients were stratified into quartiles based on PNI and analyzed for 30-day, 60-day, and 90-day all-cause mortality. Multivariable Cox regression models adjusted for potential confounders, and restricted cubic splines examined the relationship between PNI and mortality risk.ResultsA total of 701 patients were included in the analysis. Patients in the highest PNI quartile had significantly lower 30-day, 60-day, and 90-day all-cause mortality rates compared to those in the lowest quartile. After adjusting for covariates, higher PNI remained an independent predictor of reduced mortality (30-day HR 0.96, 95% CI: 0.93–0.98, p < 0.001; 60-day HR 0.96, 95% CI: 0.94–0.98, p < 0.001; 90-day HR 0.97, 95% CI: 0.95–0.99, p = 0.002).ConclusionPNI is independently associated with lower mortality in critically ill IO patients, supporting its utility as a risk stratification tool in this population. These findings underscore the importance of early nutritional assessment and intervention, and highlight PNI’s potential to guide clinical decision-making in the ICU setting. |
| format | Article |
| id | doaj-art-e230b5dc42074120b40d9cfa31844bae |
| institution | Kabale University |
| issn | 2296-861X |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Nutrition |
| spelling | doaj-art-e230b5dc42074120b40d9cfa31844bae2025-08-20T03:45:44ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2025-06-011210.3389/fnut.2025.15832011583201Association between prognostic nutritional index and all-cause mortality among intestinal obstruction patients in the intensive care unit: a retrospective studyYuanshuo Ge0Yuanshuo Ge1Zhe Wang2Cheng Zhang3Department of General Surgery, General Hospital of Northern Theater Command (Formerly Called General Hospital of Shenyang Military Area), Shenyang, ChinaJinzhou Medical University, Jinzhou, ChinaDepartment of General Surgery, General Hospital of Northern Theater Command (Formerly Called General Hospital of Shenyang Military Area), Shenyang, ChinaDepartment of General Surgery, General Hospital of Northern Theater Command (Formerly Called General Hospital of Shenyang Military Area), Shenyang, ChinaBackgroundIntestinal obstruction (IO) is a common surgical emergency associated with significant morbidity and mortality, particularly in critically ill ICU patients. The Prognostic Nutritional Index (PNI), calculated using serum albumin levels and total lymphocyte counts, has demonstrated prognostic value in various conditions. However, its role in critically ill IO patients remains unexplored.MethodsWe conducted a retrospective cohort study using the MIMIC-IV database. Critically ill patients with IO were identified, and their PNI values on the first day of ICU admission were recorded. Patients were stratified into quartiles based on PNI and analyzed for 30-day, 60-day, and 90-day all-cause mortality. Multivariable Cox regression models adjusted for potential confounders, and restricted cubic splines examined the relationship between PNI and mortality risk.ResultsA total of 701 patients were included in the analysis. Patients in the highest PNI quartile had significantly lower 30-day, 60-day, and 90-day all-cause mortality rates compared to those in the lowest quartile. After adjusting for covariates, higher PNI remained an independent predictor of reduced mortality (30-day HR 0.96, 95% CI: 0.93–0.98, p < 0.001; 60-day HR 0.96, 95% CI: 0.94–0.98, p < 0.001; 90-day HR 0.97, 95% CI: 0.95–0.99, p = 0.002).ConclusionPNI is independently associated with lower mortality in critically ill IO patients, supporting its utility as a risk stratification tool in this population. These findings underscore the importance of early nutritional assessment and intervention, and highlight PNI’s potential to guide clinical decision-making in the ICU setting.https://www.frontiersin.org/articles/10.3389/fnut.2025.1583201/fullprognostic nutritional indexintestinal obstructionICUmortalityMIMIC-IVnutritional status |
| spellingShingle | Yuanshuo Ge Yuanshuo Ge Zhe Wang Cheng Zhang Association between prognostic nutritional index and all-cause mortality among intestinal obstruction patients in the intensive care unit: a retrospective study Frontiers in Nutrition prognostic nutritional index intestinal obstruction ICU mortality MIMIC-IV nutritional status |
| title | Association between prognostic nutritional index and all-cause mortality among intestinal obstruction patients in the intensive care unit: a retrospective study |
| title_full | Association between prognostic nutritional index and all-cause mortality among intestinal obstruction patients in the intensive care unit: a retrospective study |
| title_fullStr | Association between prognostic nutritional index and all-cause mortality among intestinal obstruction patients in the intensive care unit: a retrospective study |
| title_full_unstemmed | Association between prognostic nutritional index and all-cause mortality among intestinal obstruction patients in the intensive care unit: a retrospective study |
| title_short | Association between prognostic nutritional index and all-cause mortality among intestinal obstruction patients in the intensive care unit: a retrospective study |
| title_sort | association between prognostic nutritional index and all cause mortality among intestinal obstruction patients in the intensive care unit a retrospective study |
| topic | prognostic nutritional index intestinal obstruction ICU mortality MIMIC-IV nutritional status |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2025.1583201/full |
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