The value of prognostic nutritional index in patients with deep neck space infection

Abstract

Background: Antibiotic therapy is pivotal in deep neck space infections, yet inappropriate use and antibiotic resistance impact patient outcomes. Aim: This study aimed to evaluate the clinical significance of admission prognostic nutritional index (PNI) as a prognostic marker. Methods: Data from 81 hospitalized patients (mean age 33.9 years) with deep neck space infections confirmed by CT scans were analyzed (Nov 2020 ‑ Sep 2023). PNI, derived from serum albumin and lymphocyte count, was calculated. Primary outcome was antibiotic resistance; secondary outcome was length‑of‑stay. Results: Patients with antibiotic resistance (n = 24) had significantly lower PNI (mean 47.3, SD = 9.2) compared to the non‑resistant group (n = 57, mean 57.5, SD = 12.2), P < 0.001. Adjusted multivariable analysis showed PNI as a significant predictor of antibiotic resistance (OR = 0.908, 95% CI 0.837‑0.984, P = 0.004). ROC analysis established a PNI cut‑off of 51.5 with 59% sensitivity and 80% specificity. Linear regression revealed decreasing PNI associated with prolonged length‑of‑hospital stays (adjusted R‑squared = 0.40, P = 0.010). Conclusions: The study underscores PNI’s potential as a prognostic marker for deep neck space infections, particularly in predicting antibiotic resistance and length of hospital stay. Lower PNI values correlate with compromised nutritional and immune status, suggesting its clinical relevance for personalized treatment strategies.