{
  "abstract": "Background\n\nThe prognostic nutritional index (PNI) combines albumin and lymphocyte count and may capture nutrition-related immune-inflammatory status in sepsis. Whether its association with mortality differs by left ventricular ejection fraction (LVEF)-defined septic cardiomyopathy (SCM) is unclear.Methods\n\nWe conducted a retrospective 72-h landmark study of MIMIC-IV adults with Sepsis-3 who survived to the landmark, had clinically indicated pre-landmark echocardiographic LVEF assessment, and had calculable early PNI. The prespecified primary analysis tested the lower-PNI-by-LVEF-defined-SCM interaction for 28-day mortality in an adjusted Cox model. Ninety-day and sensitivity analyses were supportive or exploratory. A single-center cohort was examined separately, not as formal validation.Results\n\nAmong 1,976 patients, 240 had LVEF-defined SCM; 506 and 633 died by 28 and 90 days, respectively. Each 5-point lower PNI was associated with higher 28-day mortality without SCM (adjusted hazard ratio [HR], 1.18; 95% CI, 1.11-1.24) but not with LVEF-defined SCM (HR, 0.96; 95% CI, 0.87-1.05); the ratio of HRs was 0.82 (95% CI, 0.73-0.91; p < 0.001). The secondary 90-day ratio was 0.84 (95% CI, 0.76-0.94; nominal p = 0.001). Absolute-risk and restricted-mean-survival-time analyses supported attenuation, whereas same-calendar-day PNI pairing and some alternative LVEF definitions attenuated the interaction estimates toward the null. The external estimate was imprecise and statistically inconclusive (ratio of odds ratios, 0.89; 95% CI, 0.51-1.55).Conclusion\n\nAmong selected 72-h survivors with clinically indicated pre-landmark echocardiography, the association between lower PNI and 28-day mortality was attenuated with LVEF-defined SCM. PNI should not be used alone for nutritional or clinical decision-making.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Emergency, Linyi People's Hospital, Linyi, Shandong, China.",
    "Department of Emergency Surgery, Linyi People's Hospital, Linyi, Shandong, China.",
    "Department of Critical Care Medicine, Linyi People's Hospital, Linyi, Shandong, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Xianju Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Min Cheng"
    },
    {
      "affs": [
        1
      ],
      "name": "Fengqi Ruan"
    },
    {
      "affs": [
        2
      ],
      "name": "Chong Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Shuai Wang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1zjhxfpkqm2ev.bib",
  "cited_by": 0,
  "doi": "10.3389/fnut.2026.1903225",
  "fulltext_url": "https://europepmc.org/articles/PMC13680185",
  "id": "1zjhxfpkqm2ev",
  "issns": [
    "2296-861X"
  ],
  "landing_url": "https://europepmc.org/article/MED/42903086",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2713|Sepsis Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7220690469",
  "pdf_url": "https://europepmc.org/articles/PMC13680185?pdf=render",
  "pmcid": "PMC13680185",
  "pmid": "42903086",
  "published": "2026-10-06",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/1zjhxfpkqm2ev.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:57Z",
      "native_id": "MED:42903086",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42903086"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Sepsis Diagnosis and Treatment",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "LVEF-defined septic cardiomyopathy modifies the association between the prognostic nutritional index and mortality in adults with sepsis: a 72-h landmark analysis.",
  "title_text": "LVEF-defined septic cardiomyopathy modifies the association between the prognostic nutritional index and mortality in adults with sepsis: a 72-h landmark analysis.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:57Z",
  "url": "https://research.draconitic.com/paper/1zjhxfpkqm2ev",
  "venue": "Frontiers in nutrition",
  "versions": []
}