{
  "abstract": "Objective\n\nTo evaluate the predictive value of the preoperative Prognostic Nutritional Index (PNI) for multidimensional postoperative outcomes in elderly patients undergoing major abdominal surgery.Methods\n\nThis single-center retrospective cohort study included 761 patients aged ≥65 years from 2015 to 2025. Patients were stratified into low-PNI (<40) and high-PNI (≥40) groups. The primary outcome was postoperative delirium within 7 days. Secondary outcomes included 90-day mortality, Clavien-Dindo classification, postoperative hospital stay, and functional recovery milestones (time to first ambulation, oral intake, and defecation). Multivariable regression models (logistic, Cox proportional hazards, and competing risk Fine-Gray models) were employed, adjusting for age, ASA grade, surgical factors, and comorbidities. PNI was further stratified into four categories (<35, 35-40, 40-45, and >45) for dose-response trend analysis.Results\n\nCompared to the low-PNI group, the high-PNI group had a significantly lower risk of postoperative delirium (adjusted odds ratio [aOR] =0.21, 95% confidence interval [CI]:0.13-0.35, P < 0.001), 90-day mortality (adjusted hazard ratio [aHR] = 0.22, 95% CI: 0.10-0.48, P < 0.001), and severe complications (OR = 0.18, 95% CI: 0.12-0.27, P < 0.001). In the competing risk analysis, high PNI was independently associated with faster achievement of all functional recovery milestones (all subdistribution hazard ratios [SHR] >1, P < 0.001). The dose-response analysis confirmed a significant gradient effect: Each increment in PNI category was associated with progressively lower risks of adverse events and faster recovery.Conclusion\n\nPreoperative PNI is a robust, independent predictor of multiple postoperative outcomes in elderly abdominal surgery patients. As a simple and cost-effective tool, PNI is well suited for preoperative risk stratification and guiding personalized perioperative management.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Anesthesiology, PLA Rocket Force Characteristic Medical Center, Beijing, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ruowen Xing"
    },
    {
      "affs": [
        0
      ],
      "name": "Zhixiang Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Xiaomeng Sun"
    },
    {
      "affs": [
        0
      ],
      "name": "Yuheng Ma"
    },
    {
      "affs": [
        0
      ],
      "name": "Hao Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Guanhua Li"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/e2qc0355bbmg5.bib",
  "cited_by": 0,
  "doi": "10.4103/sja.sja_155_26",
  "fulltext_url": "https://europepmc.org/articles/PMC13719092",
  "id": "e2qc0355bbmg5",
  "issns": [
    "1658-354X",
    "0975-3125"
  ],
  "landing_url": "https://europepmc.org/article/MED/42960350",
  "language": "eng",
  "licence": "CC-BY-NC-SA",
  "licence_label": "CC BY-NC-SA",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-sa/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2730|Inflammatory Biomarkers in Disease Prognosis"
    ]
  ],
  "openalex": "W7215036956",
  "pdf_url": "https://europepmc.org/articles/PMC13719092?pdf=render",
  "pmcid": "PMC13719092",
  "pmid": "42960350",
  "published": "2026-10-01",
  "publisher": "Wolters Kluwer -- Medknow Publications",
  "ris": "https://research.draconitic.com/paper/e2qc0355bbmg5.ris",
  "sources": [
    {
      "first_seen": "2026-11-01T00:20:52Z",
      "native_id": "MED:42960350",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42960350"
    },
    {
      "first_seen": "2026-11-02T12:22:59Z",
      "native_id": "PMC13719092",
      "source": "pmc",
      "url": "https://doi.org/10.4103/sja.sja_155_26"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2730|Inflammatory Biomarkers in Disease Prognosis",
      "subfield": "oncology"
    }
  ],
  "title": "Multidimensional prognostic value of preoperative Prognostic Nutritional Index for postoperative outcomes in older adults undergoing major open abdominal surgery.",
  "title_text": "Multidimensional prognostic value of preoperative Prognostic Nutritional Index for postoperative outcomes in older adults undergoing major open abdominal surgery.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-02T12:22:59Z",
  "url": "https://research.draconitic.com/paper/e2qc0355bbmg5",
  "venue": "Saudi journal of anaesthesia",
  "versions": []
}