Data Sheet 1_Prognostic value of the prognostic nutritional index in sepsis, pneumonia, and tuberculosis: a systematic review and meta-analysis.pdf

Disease-stratified meta-analysis underscores PNI's prognostic association in infectious diseases. Notably, among sepsis patients, elevated baseline PNI is associated with a significantly attenuated mortality risk (hazard ratio [HR]: 0.63; 95% confidence interval [CI]: 0.44, 0.90). Similarly, in the pneumonia subgroup, a high PNI demonstrated a significant inverse association with mortality (HR: 0.47; 95% CI: 0.30, 0.73).

Conversely, in the tuberculosis subgroup, the association between PNI and mortality did not reach statistical significance (HR: 0.38; 95% CI: 0.04, 3.82). Overall, higher PNI remained a significant protective factor against mortality or unfavorable clinical outcomes (pooled HR: 0.52; 95% CI: 0.39, 0.71; P < 0.0001), with leave-one-out sensitivity analyses confirming the stability of these findings. Neither Begg's test (P = 0.2219) nor Egger's test (P = 0.1009) provided statistical evidence of small-study effects, although the limited number of included studies reduces the power of these tests.</p>Conclusions<p>Reduced baseline PNI correlates with heightened mortality in sepsis and pneumonia, yet its prognostic value in tuberculosis remains uncertain.

Although PNI is a cost-effective clinical adjunct, the current evidence is too heterogeneous to support its universal use in infectious diseases. Addressing these gaps requires large-scale prospective investigations across a wider spectrum of diseases.</p>