Prognostic Nutritional Index as a Potential Biomarker for the Risk of Lower Extremity Deep Venous Thrombosis: A Large Retrospective Study

Abstract

Background Prognostic nutritional index (PNI) has recently been identified as a novel marker of nutritional status. However, existing evidences on the association between PNI and the risk of lower extremity deep venous thrombosis (LEDVT) are limited and conflicting. Objective To determine the association between PNI and the risk of LEDVT, and further evaluate its diagnostic value. Methods Over a 10-year period (2012–2022), a total of 12790 patients who underwent compression ultrasonography examinations were consecutively included, and 1519 (11.9%) LEDVT events occurred. Multivariate logistic regression analysis was used to investigate the association, and receiver operating characteristic (ROC) curve was constructed to evaluate its diagnostic performance. Results After full adjustment, patients in third quartile (odds ratio [OR] = 1.486, 95% confidence interval [CI]: 1.205–1.832), second quartile (OR = 2.436, 95% CI: 1.993–2.978) and first quartile (OR = 3.422, 95% CI: 2.791–4.195) of PNI were at higher risk of LEDVT compared with those in fourth quartile, and the test for trend was significant. Consistently, each unit decrease in PNI was associated with a 6.0 % (95% CI: 1.052–1.069) increased risk of LEDVT. Moreover, adding PNI to a base model improved the area under the curve (AUC) from 0.721 (95% CI: 0.709–0.734) to 0.746 (95% CI: 0.734–0.758). Conclusion PNI is inversely associated with the risk of LEDVT, and provides significant incremental diagnostic value for the identification of LEDVT events. These findings suggest that PNI may be a potential biomarker to help clinicians identify patients at risk of thrombosis and make clinical decisions timely.