Using Prognostic Nutritional Index and Systemic Immune-Inflammation Index to Evaluate Short-Term Survival in Hospitalized Octogenarian and Non-agenarian Patients

Abstract

Objective: This study aimed to investigate the associations between the preoperative Prognostic Nutritional Index (PNI), Systemic Immune-Inflammation Index (SII), and short-term survival in octogenarian and non-agenarian patients who were admitted to the urology department. Materials and Methods: We evaluated 136 octogenarian and non-agenarian patients who were admitted to the urology department. The patient-related data were collected, including demographic and comorbidities. Surgical treatment patterns and outcomes were assessed. Patients’ SII and PNI scores were calculated. PNI was calculated as total lymphocyte count (109/L) × 5 + albumin concentration (g/L). SII was calculated as neutrophil count (109/L) × platelet count (109/L)/lymphocyte count (109/L). The cut-off values of PNI and SII were determined through receiver operating characteristic analysis. Overall survival (OS) was estimated by Kaplan-Meier analysis. The log-rank test was used to compare differences between the groups. Univariate and multivariate COX regression analyses were performed to assess the predictive values of PNI and SII for OS. Results: The study population comprised 105 women (77.2%) and 31 men (22.8%), with a median age of 84 years (range, 80-97 years). The most common reason for hospitalization was hematuria, affecting 47 patients (34.6%). A total of 74 patients (54.4%) underwent surgical intervention. The optimal cut-off values for predicting OS were identified as 1243, 42.65, and 32.37 for SII, PNI, and SII/PNI, respectively. Kaplan-Meier analysis also revealed that low PNI was related to poorer OS in octogenarian and non-agenarian patients. Conclusion: Preoperative PNI and SII, based on standard laboratory measurements, may be useful non-invasive, inexpensive, and simple tools for predicting short-term survival of octogenarian and non-agenarian patients admitted to the urology department. © 2025 Elsevier B.V., All rights reserved.