Abstract: Objective To explore the significance of prognostic nutrition index (PNI) in patients with sepsis caused by pyogenic liver abscess (PLA). Methods The clinical data of 202 patients with PLA in our hospital were retrospectively analyzed, and the patients were divided into sepsis group and non-sepsis group according to the SOFA criteria. The sepsis group was divided into survival group and death group according to prognosis. General information was compared between the two groups. Univariate and multivariate Logistic regression were used to evaluate the effect of PNI on the prognosis of PLA patients with sepsis. Receiver operating characteristic (ROC) curve was plotted and area under the curve (AUC) was calculated to assess the prognostic significance of PNI in PLA patients with sepsis. Results The SOFA score, WBC, ALT, AST, ALP, TBil, Scr, BUN, PT, APTT, CRP, and size of liver abscess in the sepsis group were significantly higher than those in non-sepsis group (P<0.05). The LYM, PLT, ALB and PNI in the sepsis group were significantly lower than those in non-sepsis group (P< 0.05). Multivariate logistic regression analysis showed that PLT, ALT, AST, TBil, Alb, PNI, Scr and APTT were independent risk factors for PLA patients complicated with sepsis. Area under the ROC curve: PNI was 0.843. Using the Youden index, the optimal cutoff value of PNI was 34.7, with a sensitivity of 75.7% and a specificity of 81.8%.The results showed that when PNI＜34.7, patients were at greater risk of developing sepsis. The correlation between PNI and SOFA score was R=-0.523 (P<0.05). The SOFA score, TBil and BUN in the death group were significantly higher than those in the survival group (P< 0.05). The PLT and PNI of the death group were significantly lower than those in the survival group (P< 0.05). There was a statistically significant difference (P<0.05) in the treatment plans (liver puncture drainage, use of pressor drugs) between the death group and the survival group. Concurrent septic shock, acute kidney injury, and liver failure are related factors for mortality in PLA patients with sepsis (P<0.05).Multivariate regression analysis showed that PNI was an independent risk factor for death in PLA patients with sepsis. Conclusion PNI can predict the occurrence of sepsis in PLA patients. When PNI<34.7, the risk of progression to sepsis was higher. PNI can predict poor prognosis of PLA patients complicated with sepsis.

Key words: Pyogenic liver abscess, Sepsis, Prognostic nutrition index