Abstract: Objective To investigate the predictive value of prognostic nutritional index (PNI) combined with systemic inflammatory response index (SIRI) for the short-term prognosis of patients with acute decompensated cirrhosis. Methods One hundred and twelve patients with acute decompensated cirrhosis admitted to the Second Affiliated Hospital of Dali University from January 2020 to November 2024 were collected as the study subjects. The patients were followed up for 3 months to observe their survival status and categorized into a survival group (n=82) and a death group (n=30). The baseline data of these two groups of patients were compared and the independent risk factors affecting short-term mortality of patients with acute decompensated cirrhosis and the predictive value of PNI combined with SIRI for the short-term prognosis of patients with acute decompensated cirrhosis were analyzed. Results In the death group, the Child-Turcotte-Pugh (CTP) score, percentage of CTP grade C, Model for end-stage liver disease (MELD) score, CLIF Consortium Acute Decompensation (CLIF-C AD) score, white blood cells count (WBC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), and SIRI were (10.53±2.01) points, 63.3% (19/30), (17.33±8.76)points, (56.75±12.20) points, 6.55 (4.01, 12.33)×10⁹/L, 33.15 (18.68, 59.48) U/L, 69.50 (37.40, 118.68) U/L, 63.85 (37.35, 137.15) μmol/L, and 31.08±7.15, respectively, which were higher than those of (7.80±1.56) points, 14.2% (12/82), (8.19±4.78) points, (46.16±7.62) points, 4.33 (2.96, 6.15)×10⁹/L,19.35 (13.45, 32.08) U/L, 28.55 (21.85, 58.20) U/L, 24.00 (16.08, 47.8) μmol/L, and 37.56±4.13 in the survival group, and the difference was statistically significant (P<0.05). The red blood cells count (RBC) and PNI were (2.82±0.83)×10¹²/L and 31.08±7.15 in the death group, which were lower than those of (3.20±0.76)×10¹²/L and 37.56±4.13 in the survival group, and the differences were statistically significant (P<0.05). By one-way logistic regression analysis it was shown that RBC, ALT, TBil, SCr, PNI, SIRI, CTP score, MELD score, and CLIF-C AD score were the influencing factors of the short-term poor prognosis in patients with acute decompensated cirrhosis (P<0.05). By multifactorial logistic regression analysis it was shown that SCr, PNI, SIRI, and CTP score were still the independent risk factors of short-term poor prognosis in patients with acute decompensated cirrhosis (P<0.05). By ROC curves analysis it was shown that the AUC of SIRI, PNI alone and SIRI combined with PNI for predicting short-term poor prognosis in patients with acute decompensated cirrhosis were 0.652(95%CI=0.522~0.782), 0.782(95% CI=0.674~0.889), and 0.846(95%CI=0.753~0.939), respectively (P<0.05). Conclusion PNI and SIRI, as two simple and readily available serologic indices, have better efficacy in combination for predicting short-term mortality risk in patients with acute decompensated cirrhosis.

Key words: Prognostic nutritional index, Systemic inflammatory response index, Acute decompensated cirrhosis, Influence factor;Prognosis