Association between Prognostic Nutritional Index and community-acquired pneumonia in children with parapneumonic effusion: A retrospective analysis: Prognostic Nutritional Index and parapneumonic effusion

Özlem Erdede; Erdal Sarı

doi:10.5281/zenodo.8350562

Authors

Özlem Erdede University of Health Sciences, Zeynep Kamil Maternity and Children’s Disease Training and Research Hospital, Department of Pediatrics, İstanbul, Turkey https://orcid.org/0000-0002-5490-5361
Erdal Sarı University of Health Sciences, Zeynep Kamil Maternity and Children’s Disease Training and Research Hospital, Department of Pediatrics, İstanbul, Turkey https://orcid.org/0000-0002-9967-1669

DOI:

https://doi.org/10.5281/zenodo.8350562

Keywords:

Children, lobar pneumonia, parapneumonic effusion, Prognostic Nutritional Index

Abstract

Objective: Biomarkers for predicting disease severity in patients with clinical pneumonia have been increasingly reported. The association of Prognostic Nutritional Index (PNI), an inflammation-based marker, with community-acquired pneumonia (CAP) is uncertain. This study ascertained the relationship between PNI and CAP in children with parapneumonic effusion (PPE).

Methods: This single-center study retrospectively included 679 children hospitalized with lobar pneumonia between January 1, 2012, and July 31, 2022, and subdivided the cohort by PPE presence (n=209) or absence (n=470). The length of hospital stay and PNI at hospitalization were compared among patients with only lobar pneumonia; pneumonia + PPE; and PPE + use of chest tube drainage (PPE+tube drainage).

Results: Significant intergroup differences (p=0.0001) in PNI were observed among the lobar pneumonia, PPE, and PPE+tube drainage groups: PNI in the PPE+tube drainage group was significantly lower than that in the lobar pneumonia and PPE groups, and PNI of the PPE group was significantly lower than that in the lobar pneumonia group. The area under the PNI receiver operating characteristics curve (with 95% CI) was 0.671 (0.633–0.707) and 0.921 (0.894–0.943) for PPE and PPE+tube drainage, respectively. A PNI cut-off ≤38.01 for PPE+tube drainage showed sensitivity of 87.88, specificity of 88.30, positive predictive value of 34.50, negative predictive value of 99.00, and likelihood ratio (+) of 7.51. The length of hospital stay (days) was longer in the PPE+tube drainage group.

Conclusion: PNI at admission may constitute an independent predictor of CAP prognosis in patients who require tube drainage.

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