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TL;DR
Low PNI was significantly associated with higher mortality and MACE, while increasing PNI was associated with lower risk of both outcomes.
Frontiers in Nutrition · 7 authors, 2 centres
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Low PNI was significantly associated with higher mortality and MACE, while increasing PNI was associated with lower risk of both outcomes.
Studies were identified from PubMed, Web of Science, Scopus, and Embase through November 2022. Random-effects meta-analyses were conducted with PNI analyzed as both categorical and continuous variables, supplemented by subgroup analyses for region, sample size, and patient diagnosis. Low PNI was significantly associated with increased mortality (HR: 1.67) and MACE (HR: 1.57) compared to high PNI, while each unit increase in continuous PNI was associated with lower mortality (HR: 0.94) and MACE (HR: 0.84). Major limitations include high inter-study heterogeneity (I² ranging from 89% to 97%), variable PNI cut-offs across studies, and predominance of studies from Asian and European countries. Sensitivity analyses and absence of publication bias supported the robustness of the mortality findings, though MACE results as a categorical variable lost significance on sensitivity analysis.