The effect of prognostic nutritional index and hgb/rdw level on morbidity in children with pneumonia.

Background: Pneumonia in children remains a significant public health concern as it records high cases of morbidity and mortality especially in developing countries. This research work is the first in the literature which systemically looks at the association of Prognostic Nutritional Index (PNI) as well as Hemoglobin/RDW (Hgb/RDW) ratio with morbidity in childhood pneumonia. No research so far has explored the prognostic value of PNI in children suffering from pneumonia, and hence this study seeks to bridge this critical knowledge gap.

Methods: This retrospective case-control study was conducted in Balıkesir Atatürk City Hospital. The study included 150 children diagnosed with community-acquired pneumonia and 150 healthy control subjects of similar age group. PNI was calculated using the formula "(10 x serum albumin [g/dL]) + (0.005 x absolute lymphocyte count [x10^9/L])". Hgb/RDW ratio was obtained by dividing hemoglobin value by RDW. Demographic data, laboratory findings and clinical observations were collected from all participants.

Results: PNI values of the pneumonia group were significantly lower than those of the control group (42.4 vs. 48.6, p < 0.001). In addition, low PNI (< 40) and high Hgb/RDW ratios were found to be significantly associated with length of hospitalization, need for oxygen support and need for mechanical ventilation. A strong negative correlation was found between PNI and length of hospital stay (r=-0.682, p < 0.001) and recovery time (r=-0.724, p < 0.001), while Hgb/RDW ratio was significantly associated with these clinical indicators. In the ROC analysis, the AUC value expressing the predictive power of PNI for pneumonia severity was 0.874.

Conclusions: In childhood pneumonia, both PNI and Hgb/RDW ratio may be effective markers for predicting disease severity and clinical course. Low PNI and high Hgb/RDW ratios have been associated with prolonged hospitalization and increased risk of complications.