The Relation Between the Prognostic Nutritional Index and 30-Day Mortality in Patients With Acute Respiratory Distress Syndrome: A Retrospective Study Based on the MIMIC-IV Database.

INTRODUCTION

Acute respiratory distress syndrome (ARDS) has a high mortality rate. The prognostic nutritional index (PNI), as a comprehensive indicator of nutritional and immune status, has shown prognostic value in various diseases, however, its role in predicting prognosis in ARDS remains uncertain.

MATERIALS AND METHODS

This study is a retrospective study based on data from the Medical Information Mart for Intensive Care IV database. This study enrolled 2829 patients with ARDS. Kaplan-Meier survival curve and Cox proportional hazard model were applied to analyze the association between PNI and 30-d mortality in patients with ARDS according to the tertiles of PNI. Through subgroup analysis and interaction testing, further exploration was undertaken to illuminate the influence conferred by PNI on prognosis across different populations.

RESULTS

The 30-d mortality rate for ARDS patients was 26.5%. The Kaplan-Meier survival curve revealed that higher PNI indicated higher survival probability. After adjustment for all confounding factors, PNI was significantly inversely associated with 30-d mortality in patients with ARDS (hazard ratio = 0.981, 95% confidence interval: 0.969-0.993). Subgroup analysis indicated that the negative correlation between PNI and 30-d mortality was more pronounced in males, married individuals, and those without comorbidity. In addition, PNI interacted significantly with cerebrovascular diseases, suggesting that the presence of cerebrovascular diseases may weaken the predictive efficacy of PNI.

CONCLUSIONS

PNI is an effective predictor of 30-d mortality for ARDS patients, with a higher PNI being linked with improved survival rates.