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Higher prognostic nutritional index associated with lower all-cause mortality in ischemic stroke cohortCould a simple nutrition score predict survival after a stroke?

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Key Takeaway
Interpret PNI association with mortality in ischemic stroke as observational, not causal.

A retrospective cohort study examined the association between prognostic nutritional index (PNI) and all-cause mortality in 1,152 consecutive ischemic stroke patients discharged from Dandong Central Hospital between January and December 2024. The study followed patients for a median of 14.23 months, with 96 patients (8.3%) experiencing all-cause mortality during follow-up.

Each 1-unit increase in PNI was associated with an 8.5% reduction in all-cause mortality risk (hazard ratio=0.915, 95% confidence interval: 0.883–0.947). The study did not report specific safety or tolerability data related to PNI assessment, as this was an observational analysis of an existing index rather than an intervention trial.

Key limitations include the retrospective observational design, which establishes association rather than causation, and the single-center setting at Dandong Central Hospital. The study did not report funding sources or conflicts of interest. While these findings suggest PNI may have prognostic value in ischemic stroke patients, they should be interpreted cautiously due to the observational nature of the evidence and need for prospective validation in diverse populations.

After someone has a stroke, doctors look for clues about their recovery. A new study from a single hospital in China suggests one clue might be found in a simple measure of nutrition, called the Prognostic Nutritional Index (PNI). This score is calculated from two common blood tests: one for protein and one for a type of white blood cell.

The research looked back at the records of 1,152 patients who had an ischemic stroke, which is caused by a blocked blood vessel in the brain. They found that for every one-point increase in a patient's PNI score, their risk of dying from any cause in the following year was about 8.5% lower. During the study period, 96 patients (8.3%) passed away.

It's important to understand what this study does and doesn't tell us. Because it was a retrospective study—meaning it looked at past records—it can only show an association, not prove that better nutrition directly causes better survival. The findings come from just one hospital, so they might not apply to everyone. The study also didn't track what patients ate or any specific nutritional treatments they received. This research is a starting point, suggesting that paying attention to a patient's nutritional health could be important, but more work is needed to understand why this link exists.

What this means for you:
A simple nutrition score was linked to better survival after stroke, but more research is needed.

Study Details

Study typeCohort
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
ObjectivesThis study aims to explore the correlation between the prognostic nutritional index (PNI) and all-cause mortality in patients diagnosed with ischemic stroke (IS).MethodsA single-center retrospective cohort study was conducted at Dandong Central Hospital, enrolling 1,152 consecutive patients with IS who were discharged from January to December 2024. Multivariate Cox regression models, subgroup analysis, sensitivity analysis, receiver operating characteristic (ROC) curve, and Kaplan–Meier survival analysis were employed to investigate the association between the PNI and all-cause mortality.ResultsDuring a median follow-up period of 14.23 months, a total of 96 (8.3%) patients experienced all-cause mortality. Multivariate Cox regression analysis showed that after adjusting for multiple confounding factors, each 1-unit increase in PNI was associated with an 8.5% reduction in all-cause mortality risk (hazard ratio [HR] = 0.915, 95% confidence interval [CI]: 0.883–0.947, p
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