Skip to content
DraconiticResearch
Search Sources API
203,234 studies31 sourcesUpdated 22 min ago
Peer-reviewedCC BY 4.0Frontiers in Neurology

Association between prognostic nutritional index and mortality in older Japanese patients with severe post-stroke dysphagia requiring nutritional support: a retrospective cohort study

  • Wangchun Wu1
  • Jianling Wang1
  1. 1Department of Neurosurgery, The Affiliated Mindong Hospital of Fujian Medical University
Read full textPDFDOICite

Abstract

Background: The prognostic nutritional index (PNI), calculated from serum albumin and lymphocyte count, has remained insufficiently investigated in older patients with post-stroke dysphagia (PSD). We investigated whether PNI was associated with all-cause mortality in older Japanese patients with PSD and compared its prognostic performance with that of the C-reactive protein/albumin ratio (CAR).

Methods: This single-center retrospective cohort study included 132 older Japanese patients with severe PSD requiring PEG or TPN between January 2014 and January 2017. Multivariable Cox regression analysis and Kaplan–Meier curves were used to estimate the associations of PNI and CAR with all-cause mortality. We assessed robustness through subgroup and sensitivity analyses. To evaluate the prognostic discrimination for 1-year mortality, we used time-dependent receiver operating characteristic (ROC) curves and assessed incremental predictive value using integrated discrimination improvement (IDI) and net reclassification improvement (NRI).

Results: The mean age of the cohort was 80.7 years (78 women, 54 men). In fully adjusted models, multivariable Cox regression showed that each 1-point increment in PNI was associated with a 7% reduction in all-cause mortality (HR = 0.93, 95% CI: 0.90–0.97). Compared with the lowest PNI tertile (T1), the highest tertile (T3) showed a 75% risk reduction (HR = 0.25; 95% CI: 0.10–0.60). For 1-year mortality, the time-dependent AUC was numerically higher for PNI than for CAR (0.771 vs. 0.712; p = 0.16). Adding PNI to a clinical baseline model significantly improved discrimination (IDI = 0.055, 95% CI 0.010–0.104, p < 0.001; NRI = 0.471, 95% CI 0.126–0.957), whereas adding CAR did not (IDI = 0.015, p = 0.31).

Conclusion: PNI was inversely associated with mortality in older Japanese patients with severe post-stroke dysphagia requiring PEG or TPN and provided incremental prognostic information beyond standard clinical variables. Whether PNI may be useful for risk stratification in this population requires prospective and external validation.

Related

  1. Association Between the Naples Prognostic Score and In-Hospital Mortality in Patients with Type 2 Cardiorenal Syndrome: A Retrospective Cohort Study
    Eren Eynel, Emre Eynel, Yusuf Can
    Diagnostics (Basel, Switzerland)Peer-reviewedCC BYFull textGeneral medicineEurope PMC
  2. LVEF-defined septic cardiomyopathy modifies the association between the prognostic nutritional index and mortality in adults with sepsis: a 72-h landmark analysis.
    Xianju Wang, Min Cheng, Fengqi Ruan +2
    Frontiers in nutritionPeer-reviewedCC BYFull textEpidemiology & public healthEurope PMC
  3. Neutrophil-to-prognostic nutritional index ratio and short-term mortality in heart failure: an exploratory association without demonstrated superiority over PNI, NLR, or SII
    Zhenyu Yuan, Mohan Li, Lei Zhao +6
    Frontiers in NutritionPeer-reviewedCC BYFull textOncologyDOAJEurope PMC
  4. Controlling nutritional status score as a novel prognostic tool for hospital mortality risk stratification in sepsis: a large-scale retrospective cohort analysis.
    Wei Song, Hai-Bin Yin, Dan Liu +3
    BMC infectious diseasesPeer-reviewedCC BY-NC-NDFull textEpidemiology & public healthEurope PMCDOAJ
  5. Association of preoperative D-dimer-to-albumin ratio and prognostic nutritional index with aseptic wound complications and periprosthetic joint infection after primary total knee arthroplasty: a single-center retrospective cohort study
    Zhi-Chao Han, Xiao-Kai Liu, Peng-Yuan Su +7
    BMC Musculoskeletal DisordersPeer-reviewedCC BYFull textSurgery & anaesthesiaDOAJ

Cite

BibTeXRIS
BibTeX
@article{wu2026association,
  title = {{Association between prognostic nutritional index and mortality in older Japanese patients with severe post-stroke dysphagia requiring nutritional support: a retrospective cohort study}},
  author = {Wangchun Wu and Jianling Wang},
  journal = {Frontiers in Neurology},
  year = {2026},
  month = oct,
  doi = {10.3389/fneur.2026.1902644},
  url = {https://www.frontiersin.org/articles/10.3389/fneur.2026.1902644/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Association between prognostic nutritional index and mortality in older Japanese patients with severe post-stroke dysphagia requiring nutritional support: a retrospective cohort study
AU  - Wangchun Wu
AU  - Jianling Wang
PY  - 2026
DA  - 2026/10/19
JO  - Frontiers in Neurology
DO  - 10.3389/fneur.2026.1902644
UR  - https://www.frontiersin.org/articles/10.3389/fneur.2026.1902644/full
AB  - Background: The prognostic nutritional index (PNI), calculated from serum albumin and lymphocyte count, has remained insufficiently investigated in older patients with post-stroke dysphagia (PSD). We investigated whether PNI was associated with all-cause mortality in older Japanese patients with PSD and compared its prognostic performance with that of the C-reactive protein/albumin ratio (CAR).  Methods: This single-center retrospective cohort study included 132 older Japanese patients with severe PSD requiring PEG or TPN between January 2014 and January 2017. Multivariable Cox regression analysis and Kaplan–Meier curves were used to estimate the associations of PNI and CAR with all-cause mortality. We assessed robustness through subgroup and sensitivity analyses. To evaluate the prognostic discrimination for 1-year mortality, we used time-dependent receiver operating characteristic (ROC) curves and assessed incremental predictive value using integrated discrimination improvement (IDI) and net reclassification improvement (NRI).  Results: The mean age of the cohort was 80.7 years (78 women, 54 men). In fully adjusted models, multivariable Cox regression showed that each 1-point increment in PNI was associated with a 7% reduction in all-cause mortality (HR = 0.93, 95% CI: 0.90–0.97). Compared with the lowest PNI tertile (T1), the highest tertile (T3) showed a 75% risk reduction (HR = 0.25; 95% CI: 0.10–0.60). For 1-year mortality, the time-dependent AUC was numerically higher for PNI than for CAR (0.771 vs. 0.712; p = 0.16). Adding PNI to a clinical baseline model significantly improved discrimination (IDI = 0.055, 95% CI 0.010–0.104, p < 0.001; NRI = 0.471, 95% CI 0.126–0.957), whereas adding CAR did not (IDI = 0.015, p = 0.31).  Conclusion: PNI was inversely associated with mortality in older Japanese patients with severe post-stroke dysphagia requiring PEG or TPN and provided incremental prognostic information beyond standard clinical variables. Whether PNI may be useful for risk stratification in this population requires prospective and external validation.
SN  - 1664-2295
ER  -