Low Prognostic Nutritional Index and Mortality Risk in Patients with Spontaneous Intracerebral Hemorrhage

Background: Spontaneous intracerebral hemorrhage (ICH) is associated with a high risk of mortality and poor prognosis.ICH prognosis is closely related to nutritional status.The prognostic nutritional index (PNI) is a novel and useful marker calculated from the serum albumin concentration and lymphocyte count, which reflect inflammatory, immune, and nutritional status.We investigated the relationship between PNI and mortality in patients with supratentorial spontaneous ICH.Methods: This retrospective study included patients diagnosed with supratentorial spontaneous ICH between January 2012 and June 2024.The sample was divided into survivors discharged from the hospital (n=65) and those who died in hospital (n=52).A PNI cut-off value, determined by receiver-operating characteristic curve analysis, was used to divide the sample further into high and low PNI groups for subsequent analysis. Results:The low PNI group (<48.02) had significantly higher National Institutes of Health Stroke Scale scores, hematoma volumes, and lymphocyte and neutrophil counts, but lower hospital stay durations and albumin levels (P<.05) than the high PNI group.Univariate logistic regression analysis showed that the 28-day mortality rate was 2.391 times higher in the low PNI group than in the high PNI group (P<.005).Multivariate logistic regression analysis adjusted for confounding variables revealed that the 28-day mortality rate was 2.463 times higher in the low PNI group than in the high PNI group.The age subgroup analysis showed that the accuracy of the PNI cut-off value was higher in patients less than 70 years old (65.4%) than in those aged 70 years and older (58%). Conclusion:Lower PNI values were associated with a worse prognosis in patients with supratentorial spontaneous ICH.Further studies in larger populations are needed to validate our findings.