Clinical value of prognostic nutritional index in predicting the presence and severity of neonatal sepsis

Abstract

Aim: The Prognostic Nutritional Index (PNI) is a novel inflammation biomarker that reflects the nutritional and inflammatory status of patients. While there are studies on its use in cancer, cardiovascular, and renal diseases, there are no studies on preterm neonatal late sepsis. This study aims to emphasize the value of PNI in neonatal sepsis. Materials and Methods: Newborns with a birth weight of less than 1500 grams and a gestational age of less than 32 weeks, along with healthy controls, were included in the study. The ability of PNI to predict sepsis, septic shock, and mortality was evaluated. Results: PNI was an independent and inversely related parameter to the presence and severity of neonatal sepsis. The cut-off value of PNI to predict the presence of sepsis was ?49.5, with a sensitivity of 98.3% (95% CI: 91.1-100.0) and a specificity of 96% (95% CI: 86.3-99.5). The area under the curve (AUC) was 0.995 (95% CI: 0.957-1.000) (p<0.001). The optimum cut-off value of PNI to predict the presence of septic shock was ?37.1, with a sensitivity of 92.3% (95% CI: 64.0-99.8) and a specificity of 77.3% (95% CI: 67.7-85.2). The AUC was 0.894 (95% CI: 0.821-0.945) (p<0.001). The optimum cut-off value of PNI to predict mortality was ?37, with a sensitivity of 92.3% (95% CI: 64.0-99.8) and a specificity of 78.4% (95% CI: 68.8-86.1). The AUC was 0.899 (95% CI: 0.827-0.948) (p<0.001). Conclusion: PNI can be used as an independent dynamic biomarker to predict the presence and prognosis of neonatal sepsis.