C-Reactive Protein–Adjusted Prognostic Nutritional Index for Mortality Prediction in Older Adults in Intensive Care: Comparative ROC, Calibration, and Decision-Curve Analyses

November 30, 2025

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Key Points

Evaluate the effectiveness of the inflammation-adjusted prognostic nutritional index (iPNI) for predicting mortality in older ICU patients compared to traditional indices.
Single-center retrospective cohort study of adults aged ≥65 in ICU from 2018-2024.
Primary outcome assessed was ICU mortality; secondary endpoints included need for mechanical ventilation and other critical therapies.
Analysis involved DeLong tests, bootstrap validation, calibration, decision curve analysis, and logistic models.
iPNI showed superior discrimination for predicting ICU mortality with an AUC of 0.961 compared to PNI (0.901) and GNRI (0.681).
Statistical significance was noted in comparisons of iPNI with both PNI and GNRI.

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Retrospective cohort study evaluates mortality prediction in older ICU patients using a new nutritional index, suggesting improved outcomes.

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Timurkaan et al. (2025) studied this question.

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