{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:48:15Z","timestamp":1785890895138,"version":"3.56.0"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":65,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"Anhui Province Traditional Chinese Medicine Inheritance and Innovation Research Project","award":["2024CCCX029"],"award-info":[{"award-number":["2024CCCX029"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Nutr"],"DOI":"10.1186\/s40795-026-01376-3","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T12:36:09Z","timestamp":1780317369000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between prognostic nutritional index and mortality in patients with sepsis-associated delirium: a retrospective cohort study using the MIMIC-IV database"],"prefix":"10.1186","volume":"12","author":[{"given":"Sijia","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zimeng","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhize","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxiu","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiling","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"key":"1376_CR1","doi-asserted-by":"publisher","first-page":"456","DOI":"10.3390\/epidemiologia5030032","volume":"5","author":"L La Via","year":"2024","unstructured":"La Via L, Sangiorgio G, Stefani S, Marino A, Nunnari G, Cocuzza S, La Mantia I, Cacopardo B, Stracquadanio S, Spampinato S, et al. The global burden of sepsis and septic shock. Epidemiologia. 2024;5:456\u201378. https:\/\/doi.org\/10.3390\/epidemiologia5030032.","journal-title":"Epidemiologia"},{"key":"1376_CR2","doi-asserted-by":"publisher","first-page":"940779","DOI":"10.3389\/fimmu.2022.940779","volume":"13","author":"W Lei","year":"2022","unstructured":"Lei W, Ren Z, Su J, Zheng X, Gao L, Xu Y, Deng J, Xiao C, Sheng S, Cheng Y, et al. Immunological risk factors for sepsis-associated delirium and mortality in ICU patients. Front Immunol. 2022;13:940779. https:\/\/doi.org\/10.3389\/fimmu.2022.940779.","journal-title":"Front Immunol"},{"key":"1376_CR3","doi-asserted-by":"publisher","first-page":"18751","DOI":"10.1038\/s41598-024-69332-4","volume":"14","author":"L Zhang","year":"2024","unstructured":"Zhang L, Li X, Huang J, Yang Y, Peng H, Yang L, Yu X. Predictive model of risk factors for 28-day mortality in patients with sepsis or sepsis-associated delirium based on the MIMIC-IV database. Sci Rep. 2024;14:18751. https:\/\/doi.org\/10.1038\/s41598-024-69332-4.","journal-title":"Sci Rep"},{"key":"1376_CR4","doi-asserted-by":"publisher","first-page":"240","DOI":"10.3390\/medicina56050240","volume":"56","author":"B Atterton","year":"2020","unstructured":"Atterton B, Paulino MC, Povoa P, Martin-Loeches I. Sepsis associated delirium. Med (Mex). 2020;56:240. https:\/\/doi.org\/10.3390\/medicina56050240.","journal-title":"Med (Mex)"},{"key":"1376_CR5","doi-asserted-by":"publisher","first-page":"e572","DOI":"10.1016\/j.wneu.2024.02.077","volume":"185","author":"H Guo","year":"2024","unstructured":"Guo H, Yang L, Liu J, Yu X, Chen L, Huang Y. Prognostic nutritional index and the risk of postoperative complications after spine surgery: a meta-analysis. World Neurosurg. 2024;185:e572\u201381. https:\/\/doi.org\/10.1016\/j.wneu.2024.02.077.","journal-title":"World Neurosurg"},{"key":"1376_CR6","doi-asserted-by":"publisher","first-page":"1518295","DOI":"10.3389\/fimmu.2025.1518295","volume":"16","author":"W Xu","year":"2025","unstructured":"Xu W, Zhang L, Yang Q, Cao Y, Rao R, Lv L, Cen Q, Wei Q, Yang L. Associations of prognostic nutritional index with cardiovascular all-cause mortality among CVD patients with diabetes or prediabetes: evidence from the NHANES 2005\u20132018. Front Immunol. 2025;16:1518295. https:\/\/doi.org\/10.3389\/fimmu.2025.1518295.","journal-title":"Front Immunol"},{"key":"1376_CR7","doi-asserted-by":"publisher","first-page":"1600943","DOI":"10.3389\/fnut.2025.1600943","volume":"12","author":"M Pan","year":"2025","unstructured":"Pan M, Li Z, Sheng S, Teng X, Li Y. Prognostic nutritional index as a potential predictor of prognosis in patients with sepsis: a retrospective cohort study. Front Nutr. 2025;12:1600943. https:\/\/doi.org\/10.3389\/fnut.2025.1600943.","journal-title":"Front Nutr"},{"key":"1376_CR8","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1186\/s12933-024-02206-1","volume":"23","author":"X Wei","year":"2024","unstructured":"Wei X, Chen X, Zhang Z, Wei J, Hu B, Long N, Feng J, Luo C. Risk analysis of the association between different hemoglobin glycation index and poor prognosis in critical patients with coronary heart disease-a study based on the MIMIC-IV database. Cardiovasc Diabetol. 2024;23:113. https:\/\/doi.org\/10.1186\/s12933-024-02206-1.","journal-title":"Cardiovasc Diabetol"},{"key":"1376_CR9","doi-asserted-by":"publisher","first-page":"1603104","DOI":"10.3389\/fcimb.2025.1603104","volume":"15","author":"J Lou","year":"2025","unstructured":"Lou J, Kong H, Xiang Z, Zhu X, Cui S, Li J, Jin G, Huang N, Le X, Fan Y, et al. The J-shaped association between the ratio of neutrophil counts to prognostic nutritional index and mortality in ICU patients with sepsis: a retrospective study based on the MIMIC database. Front Cell Infect Microbiol. 2025;15:1603104. https:\/\/doi.org\/10.3389\/fcimb.2025.1603104.","journal-title":"Front Cell Infect Microbiol"},{"key":"1376_CR10","doi-asserted-by":"publisher","unstructured":"Karampela I, Kounatidis D, Vallianou NG, Panagopoulos F, Tsilingiris D, Dalamaga M. Kinetics of the lactate to albumin ratio in new onset sepsis: prognostic implications. Diagnostics. 2024;14(1988). https:\/\/doi.org\/10.3390\/diagnostics14171988.","DOI":"10.3390\/diagnostics14171988"},{"key":"1376_CR11","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1186\/s10020-022-00510-8","volume":"28","author":"D Beyer","year":"2022","unstructured":"Beyer D, Hoff J, Sommerfeld O, Zipprich A, Ga\u00dfler N, Press AT. The liver in sepsis: molecular mechanism of liver failure and their potential for clinical translation. Mol Med. 2022;28:84. https:\/\/doi.org\/10.1186\/s10020-022-00510-8.","journal-title":"Mol Med"},{"key":"1376_CR12","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1186\/s13054-016-1233-5","volume":"20","author":"C Arens","year":"2016","unstructured":"Arens C, Bajwa SA, Koch C, Siegler BH, Schneck E, Hecker A, Weiterer S, Lichtenstern C, Weigand MA, Uhle F. Sepsis-induced long-term immune paralysis \u2013 results of a descriptive, explorative study. Crit Care. 2016;20:93. https:\/\/doi.org\/10.1186\/s13054-016-1233-5.","journal-title":"Crit Care"},{"key":"1376_CR13","doi-asserted-by":"publisher","first-page":"a016295","DOI":"10.1101\/cshperspect.a016295","volume":"6","author":"T Tanaka","year":"2014","unstructured":"Tanaka T, Narazaki M, Kishimoto T. IL-6 in inflammation, immunity, and disease. Cold Spring Harbor Perspect Biol. 2014;6:a016295. https:\/\/doi.org\/10.1101\/cshperspect.a016295.","journal-title":"Cold Spring Harbor Perspect Biol"},{"key":"1376_CR14","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1038\/s41590-023-01660-5","volume":"25","author":"EJ Giamarellos-Bourboulis","year":"2024","unstructured":"Giamarellos-Bourboulis EJ, Aschenbrenner AC, Bauer M, Bock C, Calandra T, Gat-Viks I, Kyriazopoulou E, Lupse M, Monneret G, Pickkers P, et al. The pathophysiology of sepsis and precision-medicine-based immunotherapy. Nat Immunol. 2024;25:19\u201328. https:\/\/doi.org\/10.1038\/s41590-023-01660-5.","journal-title":"Nat Immunol"},{"key":"1376_CR15","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1024\/0300-9831\/a000730","volume":"92","author":"I Ekinci","year":"2022","unstructured":"Ekinci I, Uzun H, Utku IK, Ozkan H, Buyukkaba M, Cinar A, Akarsu M, Kumbasar A, Tabak O. Prognostic nutritional index as indicator of immune nutritional status of patients with COVID-19. Int J Vitam Nutr Res Int Z Fur Vitam - Ernahrungsforsch J Int Vitaminol Nutr. 2022;92:4\u201312. https:\/\/doi.org\/10.1024\/0300-9831\/a000730.","journal-title":"Int J Vitam Nutr Res Int Z Fur Vitam - Ernahrungsforsch J Int Vitaminol Nutr"},{"key":"1376_CR16","doi-asserted-by":"publisher","first-page":"1080","DOI":"10.1186\/s12885-022-10145-x","volume":"22","author":"H-Y Zhang","year":"2022","unstructured":"Zhang H-Y, Xie H-L, Ruan G-T, Zhang Q, Ge Y-Z, Liu X-Y, Tang M, Song M-M, Lin S-Q, Yang M, et al. Lymphocyte to C-reactive protein ratio could better predict the prognosis of patients with stage IV cancer. BMC Cancer. 2022;22:1080. https:\/\/doi.org\/10.1186\/s12885-022-10145-x.","journal-title":"BMC Cancer"},{"key":"1376_CR17","doi-asserted-by":"publisher","unstructured":"Xu F, Zhong X. Clinical significance of the prognostic nutritional index in predicting delirium among critically ill patients: a retrospective cohort study. Crit. Care Res. Pract. 2024;2024:3807532. https:\/\/doi.org\/10.1155\/2024\/3807532","DOI":"10.1155\/2024\/3807532"},{"key":"1376_CR18","doi-asserted-by":"publisher","first-page":"27771","DOI":"10.1038\/s41598-025-13738-1","volume":"15","author":"K-L Wen","year":"2025","unstructured":"Wen K-L, Cao Y-X, Du H, Huang W-Q, Zhang A. Association between protein and energy intake during acute phase and sepsis outcomes: a retrospective cohort study. Sci Rep. 2025;15:27771. https:\/\/doi.org\/10.1038\/s41598-025-13738-1.","journal-title":"Sci Rep"},{"key":"1376_CR19","doi-asserted-by":"publisher","first-page":"367","DOI":"10.3390\/nu11020367","volume":"11","author":"K-Y Hung","year":"2019","unstructured":"Hung K-Y, Chen Y-M, Wang C-C, Wang Y-H, Lin C-Y, Chang Y-T, Huang K-T, Lin M-C, Fang W-F. Insufficient nutrition and mortality risk in septic patients admitted to ICU with a focus on immune dysfunction. Nutrients. 2019;11:367. https:\/\/doi.org\/10.3390\/nu11020367.","journal-title":"Nutrients"},{"key":"1376_CR20","doi-asserted-by":"publisher","first-page":"929316","DOI":"10.3389\/fimmu.2022.929316","volume":"13","author":"X Yan","year":"2022","unstructured":"Yan X, Yang K, Xiao Q, Hou R, Pan X, Zhu X. Central role of microglia in sepsis-associated encephalopathy: from mechanism to therapy. Front Immunol. 2022;13:929316. https:\/\/doi.org\/10.3389\/fimmu.2022.929316.","journal-title":"Front Immunol"},{"key":"1376_CR21","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.3390\/brainsci13101453","volume":"13","author":"J Hu","year":"2023","unstructured":"Hu J, Xie S, Zhang H, Wang X, Meng B, Zhang L. Microglial activation: Key players in sepsis-associated encephalopathy. Brain Sci. 2023;13:1453. https:\/\/doi.org\/10.3390\/brainsci13101453.","journal-title":"Brain Sci"},{"key":"1376_CR22","doi-asserted-by":"publisher","first-page":"3214","DOI":"10.7150\/ijbs.102234","volume":"21","author":"J Li","year":"2025","unstructured":"Li J, Jia Q, Yang L, Wu Y, Peng Y, Du L, Fang Z, Zhang X. Sepsis-associated encephalopathy: mechanisms, diagnosis, and treatments update. Int J Biol Sci. 2025;21:3214\u201328. https:\/\/doi.org\/10.7150\/ijbs.102234.","journal-title":"Int J Biol Sci"},{"key":"1376_CR23","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1038\/s41420-025-02507-8","volume":"11","author":"Y Tang","year":"2025","unstructured":"Tang Y, Hu H, Xie Q, Shen J. GAS6\/AXL signaling promotes M2 microglia efferocytosis to alleviate neuroinflammation in sepsis-associated encephalopathy. Cell Death Discovery. 2025;11:268. https:\/\/doi.org\/10.1038\/s41420-025-02507-8.","journal-title":"Cell Death Discovery"},{"key":"1376_CR24","doi-asserted-by":"publisher","first-page":"820","DOI":"10.1016\/s0008-6363(02)00492-3","volume":"55","author":"W-J Zhang","year":"2002","unstructured":"Zhang W-J, Frei B. Albumin selectively inhibits TNF alpha-induced expression of vascular cell adhesion molecule-1 in human aortic endothelial cells. Cardiovasc Res. 2002;55:820\u20139. https:\/\/doi.org\/10.1016\/s0008-6363(02)00492-3.","journal-title":"Cardiovasc Res"},{"key":"1376_CR25","doi-asserted-by":"publisher","first-page":"947","DOI":"10.1038\/s41598-020-57700-9","volume":"10","author":"JC Mossanen","year":"2020","unstructured":"Mossanen JC, Jansen TU, Pracht J, Liepelt A, Buendgens L, Stoppe C, Goetzenich A, Simon T-P, Autschbach R, Marx G, et al. Elevated circulating CD14\u2009+\u2009+\u2009CD16\u2009+\u2009intermediate monocytes are independently associated with extracardiac complications after cardiac surgery. Sci Rep. 2020;10:947. https:\/\/doi.org\/10.1038\/s41598-020-57700-9.","journal-title":"Sci Rep"},{"key":"1376_CR26","doi-asserted-by":"publisher","first-page":"2295","DOI":"10.2147\/IJGM.S409328","volume":"16","author":"J Tang","year":"2023","unstructured":"Tang J, Yuan H, Wu YL, Fu S, Pan XY. The predictive value of heparin-binding protein and D-dimer in patients with sepsis. Int J Gen Med. 2023;16:2295\u2013303. https:\/\/doi.org\/10.2147\/IJGM.S409328.","journal-title":"Int J Gen Med"},{"key":"1376_CR27","doi-asserted-by":"publisher","first-page":"1210725","DOI":"10.3389\/fcvm.2023.1210725","volume":"10","author":"L Xie","year":"2023","unstructured":"Xie L, He J, Lin X, Zhang Z, Zhuang X, Jiang D. Efficacy of prognostic nutrition index in combination with D-dimer in predicting postoperative clinical adverse events after acute type a aortic dissection: a single center retrospective study. Front Cardiovasc Med. 2023;10:1210725. https:\/\/doi.org\/10.3389\/fcvm.2023.1210725.","journal-title":"Front Cardiovasc Med"},{"key":"1376_CR28","doi-asserted-by":"publisher","first-page":"1589173","DOI":"10.3389\/fmed.2025.1589173","volume":"12","author":"W Li","year":"2025","unstructured":"Li W, Chen L, Jiang L, Zhang Z, Song K. The prognostic nutritional index as a predictor of cardiovascular and all-cause mortality in chronic kidney disease: a population-based analysis of NHANES data (1999\u20132018). Front Med (Lausanne). 2025;12:1589173. https:\/\/doi.org\/10.3389\/fmed.2025.1589173.","journal-title":"Front Med (Lausanne)"},{"key":"1376_CR29","doi-asserted-by":"publisher","first-page":"e0338086","DOI":"10.1371\/journal.pone.0338086","volume":"20","author":"M Zhou","year":"2025","unstructured":"Zhou M, Wang G, Yue P, Lin H, Chen M, Chen X, Zhao J, Xu Y. The SII-PNI score: a novel composite biomarker for personalized mortality risk prediction in peritoneal dialysis patients. PLoS ONE. 2025;20:e0338086. https:\/\/doi.org\/10.1371\/journal.pone.0338086.","journal-title":"PLoS ONE"},{"key":"1376_CR30","doi-asserted-by":"publisher","first-page":"14649","DOI":"10.2147\/JIR.S535881","volume":"18","author":"L Zhu","year":"2025","unstructured":"Zhu L, Jie S, Wu S, Chen Q, Zhang X, Yang W, Wu Y. Ineffective recanalization and complications in patients with acute ischemic stroke receiving endovascular treatment: predictive value of the c-reactive protein-albumin-lymphocyte (CALLY) index. J Inflamm Res. 2025;18:14649\u201361. https:\/\/doi.org\/10.2147\/JIR.S535881.","journal-title":"J Inflamm Res"},{"key":"1376_CR31","doi-asserted-by":"publisher","first-page":"e19028","DOI":"10.7717\/peerj.19028","volume":"13","author":"K Xie","year":"2025","unstructured":"Xie K, Zhang C, Nie S, Kang S, Wang Z, Zhang X. Prognostic nutritional index (PNI) as an influencing factor for in-hospital mortality in patients with stroke-associated pneumonia: A retrospective study. PeerJ. 2025;13:e19028. https:\/\/doi.org\/10.7717\/peerj.19028.","journal-title":"PeerJ"},{"key":"1376_CR32","doi-asserted-by":"publisher","first-page":"1112","DOI":"10.1186\/s40001-025-03340-6","volume":"30","author":"J Xu","year":"2025","unstructured":"Xu J, Zhang J, Yang L, Han Z, Yue M. Influence of early enteral nutrition on mortality of adult patients with sepsis: a meta-analysis of randomized controlled trials. Eur J Med Res. 2025;30:1112. https:\/\/doi.org\/10.1186\/s40001-025-03340-6.","journal-title":"Eur J Med Res"}],"container-title":["BMC Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40795-026-01376-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40795-026-01376-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40795-026-01376-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:28Z","timestamp":1785888028000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s40795-026-01376-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,1]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["1376"],"URL":"https:\/\/doi.org\/10.1186\/s40795-026-01376-3","relation":{},"ISSN":["2055-0928"],"issn-type":[{"value":"2055-0928","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,1]]},"assertion":[{"value":"9 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was conducted using the MIMIC-IV anonymized public database according to the protocol of the review board and ethical consent was not required.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"154"}}