INTRODUCTION: Approximately 38% of children under the age of 5 years, 24% adolescents in India are underweight, indicating chronic malnutrition. Undernutrition has been associated with immunosuppression and increased susceptibility to infection and poor prognosis. Prognostic Nutrition Index (PNI) is an objective indicator calculated using serum albumin level and lymphocyte count . Lu y et al conducted a retrospective study on relationship between Prognostic Nutritional Index and All-Cause Mortality in 5800 Critically Ill patients and concluded that PNI was an independent, inverse predictor of both short and long term all cause mortality in ICU patients, highlighting its value as a simple, objective nutritional-immune indicator in critical care
OBJECTIVES :To assess the role of prognostic nutritional index as a severity marker in mechanically ventilated children.
MATERIALS AND METHODS: A cross sectional study was conducted in Paediatric intensive care unit (PICU) of M S Ramaiah hospital, Bangalore. All the children who met the inclusion criteria were taken . PNI was calculated using the formula 10 x serum albumin (g/dl) +0.005 x total lymphocyte count (mm3). All critically ill children admitted to PICU during study period were included. Total of 186 subjects were included , out of which 93 were mechanically ventilated and 91 were non mechanically ventilated critically ill children. Data record analysis was done and PNI was calculated. Out of 93 mechanically ventilated children 34 died. PNI was used to assess the outcome and severity.
RESULTS :The mean PNI was low among non survivors when compared to survivors (48 vs 52) however there was no statistical significance (p= 0.2). The mean PNI for ventilated patients (47.02) is significantly lower than that for non-ventilated patients (56.85), with a p-value of 0.002, indicating statistical significance . PNI also had a weak positive co relation with length of hospital stay(r=0.032,p=0.75) and Paediatric risk of mortality III (PRISM 3) score( r=0.105)
CONCLUSION: PNI has a role in assessing severity of illness in critically ill children especially among mechanically ventilated.