Prognostic nutritional index at discharge as a practical bedside tool for long-term all-cause mortality risk in pneumonia-induced sepsis survivors.

Objectives: Existing research has predominantly focused on short-term outcomes of sepsis during intensive care unit (ICU) admission, with limited evidence on long-term all-cause mortality. This multicenter ambispective longitudinal cohort study aimed to evaluate the prognostic value of the prognostic nutritional index (PNI), a composite marker reflecting nutritional and immune-inflammatory status, for long-term all-cause mortality in pneumonia-induced sepsis survivors. Methods: A total of 461 pneumonia-induced sepsis survivors with recurrence-free status for at least 3 months post-discharge were retrospectively enrolled and prospectively followed for a median of 36 months. Participants were stratified into tertiles based on discharge PNI scores. The association between PNI and long-term all-cause mortality was assessed, and its prognostic performance was compared with established indicators, including the Controlling Nutritional Status (CONUT) score, modified Glasgow Prognostic Score (mGPS), blood urea nitrogen-to-albumin ratio (BAR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR). Results: Restricted cubic spline (RCS) analysis revealed an inverted L-shaped, dose-dependent negative association between PNI and long-term all-cause mortality risk ( Conclusions: These findings suggest that PNI may serve as a practical bedside tool for estimating long-term post-hospital all-cause mortality among survivors of pneumonia-induced sepsis, supporting personalized clinical decision-making and routine care as an auxiliary prognostic indicator.