ArticleInfection and drug resistance2026
Nomogram for Predicting Poor Prognosis of Newly Diagnosed Active Pulmonary Tuberculosis Based on PNI: Development and Internal Validation.
Article in Infection and drug resistance, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To investigate the correlation between the Prognostic Nutrition Index (PNI) and adverse prognosis in treatment-naive patients with active pulmonary tuberculosis(TB), and to construct and validate an individualized risk prediction nomogram. Methods: A retrospective study included 165 patients with newly diagnosed active TB from January 2022 to February 2025. Treatment outcomes at 2 and 6 months were classified as good prognosis (markedly effective) or poor prognosis (effective, ineffective, deteriorated). Optimal PNI cut-offs were determined by ROC. Predictors were selected using LASSO regression. A nomogram was constructed by multivariate Logistic regression and internally validated with 1000 bootstrap samples. Model performance was evaluated by ROC, calibration curve and decision curve analysis. Results: Optimal PNI cut-offs for poor prognosis at 2 and 6 months were 44.85 and 42.6. The nomogram achieved an AUC of 0.789 at 2 months. Adding PNI significantly improved discrimination (NRI=0.396, IDI=0.054). Calibration was satisfactory, and the model showed clinical net benefit. PNI provided greater incremental value for short-term prognosis. Conclusion: A PNI-based nomogram can effectively predict poor prognosis in newly diagnosed active TB patients. A PNI threshold of <45 is recommended for high-risk screening to enable early nutritional and immune intervention. External validation is needed before widespread application.
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