ArticleBMC infectious diseases2026
Association between albumin-based nutritional inflammation indices and all-cause mortality in patients with severe pneumonia.
Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Lactate-to-albumin ratio, C-reactive protein-to-albumin ratio, and prognostic nutritional index in acute and critical care: A focused mini-review.World journal of critical care medicine · 2026Review
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6 authors.
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Abstract
BACKGROUND AND
aimSevere pneumonia is associated with high mortality rates. Nutritional and inflammatory status significantly impacts outcomes. While albumin-based indices have been demonstrated to predict outcomes in other diseases, their role in severe pneumonia remains underexplored. This study aimed to investigate the association between albumin-based nutritional inflammation indices and all-cause mortality in patients with severe pneumonia.
methodsA retrospective cohort study was conducted using data from the SCRIPT CarpeDiem Dataset. 488 critically ill patients with severe pneumonia (188 COVID-19, 250 bacterial, 50 other viral) requiring mechanical ventilation were included. Five albumin-based indices were calculated: Neutrophil-albumin ratio (NAR), Prognostic Nutritional Index (PNI), Advanced Lung Cancer Inflammation Index (ALI), Lymphocyte × albumin index (LA), and CRP-albumin-lymphocyte index (CALLY). The primary outcome was all-cause mortality. Associations were assessed using logistic regression (continuous and quartile-based) and restricted cubic spline (RCS) analyses, adjusting for confounders (age, gender, BMI, race).
resultsThe overall mortality rate was 44.5% (n = 217). Logistic regression revealed higher NAR was associated with increased mortality risk (Continuous OR: 1.11, 95% CI: 1.03–1.20, p = 0.007; Q4 vs Q1 OR: 1.94, 95% CI: 1.17–3.23, p = 0.011). Higher PNI (Continuous OR: 0.93, 95% CI: 0.91–0.96, p < 0.001; Q4 vs Q1 OR: 0.23, 95% CI: 0.14–0.40, p < 0.001) and LA (Continuous OR: 0.99, 95% CI: 0.98–0.99, p < 0.001; Q4 vs Q1 OR: 0.33, 95% CI: 0.19–0.55, p < 0.001) were protective. Higher ALI and CALLY quartiles were also associated with reduced mortality (Q4 vs Q1 OR: 0.35, p < 0.001 and OR: 0.42, p < 0.001, respectively). RCS analyses confirmed significant non-linear associations for all indices (all overall p < 0.05).
conclusionAlbumin-based nutritional inflammation indices (NAR, PNI, ALI, LA, CALLY) are significantly associated with all-cause mortality in severe pneumonia patients. Elevated NAR is a risk factor, while higher PNI, ALI, LA, and CALLY are protective factors. These indices provide valuable prognostic information for risk stratification.
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