Prognostic Nutritional Index is A Useful Predictive Marker for Morbidity and Mortality in Surgery for Perforated Peptic Ulcer.

Background: Prognostic Nutritional Index (PNI) is a useful predictor of outcomes in surgical patients. Emergency surgery for perforated peptic ulcer (PPU) remains associated with high morbidity and mortality. However, the relationship between PNI and outcomes after PPU surgery has not been fully explored. This study aimed to assess the performance of PNI in predicting morbidity and mortality among patients undergoing surgery for PPU. Methods: This retrospective study included patients who underwent emergency surgery for PPU between 2018 and 2023. Multivariate analyses were performed to identify risk factors associated with postoperative morbidity and mortality. The predictive performance of PNI was evaluated using the area under the receiver operating characteristic curve. Results: A total of 320 patients were included. The overall morbidity and mortality rates were 26.6% and 17.8%, respectively. The PNI was significantly lower in patients who experienced morbidity or mortality. Multivariate analysis showed that a low PNI was an independent predictor of both morbidity (Odds Ratio [OR], 1.05 per-point decrease; 95% Confidence Interval [CI], 1.01-1.10; Conclusion: PNI is a reliable predictor of morbidity and mortality following surgery for PPU. A PNI-guided risk assessment could be useful for the perioperative management of PPU patients.