The impact of decreased prognostic nutritional index on the prognosis of patients with pneumonia treated with glucocorticoids: a multicenter retrospective cohort study
Abstract
Background Long-term or high-dose glucocorticoid administration can markedly impair immune responses, mask clinical indicators of pulmonary infections, and increase the susceptibility to refractory pneumonia, leading to heightened mortality risk. The Prognostic nutritional index (PNI), derived from peripheral lymphocyte count and serum albumin (ALB) levels, serves as a reliable indicator for evaluating nutritional and immune statuses across various clinical populations, including oncology patients, individuals with cardiovascular disorders, and perioperative patients. However, the predictive value of PNI in pneumonia patients receiving glucocorticoids, especially within the Chinese population, has not been sufficiently investigated. This observational analysis aimed to explore the correlation between PNI levels and all-cause mortality (ACM) in patients undergoing prolonged glucocorticoid therapy for pneumonia. Methods A retrospective cohort study was conducted utilizing data extracted from the Dryad database. Kaplan–Meier curves, multivariable Cox regression, restricted cubic splines (RCS), and subgroup analyses were used to assess the association between PNI and ACM in patients with pneumonia who received glucocorticoids. Results The study incorporated a total of 639 pneumonia patients who received glucocorticoid therapy. The ACM rates were 22.5% at 30 days and rose to 26.0% at 90 days. Multivariable Cox regression showed that, after full adjustment for potential…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 639 participants or records.
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