Abstract
Introduction
The prognostic nutritional index (PNI) is calculated using total serum lymphocyte counts and albumin levels. We aimed to analyze the role of PNI in predicting intensive care unit (ICU) referral and mortality in patients with Crimean Congo Hemorrhagic Fever (CCHF).
Materials and Methods
Our target population was adult (age>18) patients who presented between March 2015 and October 2021 within five days of symptom emergence and were diagnosed with CCHF. The predictive value of PNI was analyzed by the ROC analysis. The patients were categorized based on the severity grading scores (SGS) as mild, moderate, and severe. The relationship between PNI and ICU referral and mortality was analyzed by logistic regression analysis.
Results
Overall, 115 patients with the diagnosis of CCHF were included. 13,9% (n=16) of the patients were referred to ICU while 11,3% (n=13) died. A comparison of the patients with different SGS grades revealed that they were significantly different regarding PNI (p<0,001). There was a significant negative correlation between PNI and SGS (r=-0,662; p<0,001). PNI had a PV regarding ICU referral and mortality ((AUC=0,723 95% CI: 0,609-0,836, p=0,004, (AUC=0,738 95% CI: 0,613-0,863, p=0,005)). The PNI threshold was 36,1 for ICU referral and mortality. The rates of female patients, hospitalization periods longer than one week, platelet apheresis replacement, diabetes mellitus, bleeding history, ICU admission, and mortality were significantly higher in patients with a PNI of lower than 36,1 (p<0,05).
Conclusion
PNI can predict ICU referral and mortality in patients admitted due to CCHF.
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