Predictive role of prognostic nutritional index and geriatric nutritional risk index for postoperative mortality risk in patients with aortic dissection: a systematic review and meta-analysis.

BACKGROUND: The predictive value of prognostic nutritional index (PNI) and geriatric nutritional risk index (GNRI) for mortality risk among surgical patients with aortic dissection (AD) remains unclear. This study aimed to assess the predictive role of PNI and GNRI for postoperative mortality risk in patients with AD. METHODS: PubMed, Web of Science and Chinese National Knowledge Infrastructure (CNKI) databases were searched up to February 15, 2026. Odds ratios (ORs) were combined to assess association of PNI and GNRI with mortality risk of operated AD patients. Sensitivity, specificity, diagnostic ORs (DORs), positive likelihood ratio (LR+), negative likelihood ratio (LR-) and false positive rate (FPR) were estimated to evaluate the diagnostic performance of PNI. RESULTS: Seven studies were included and the mortality rate was 15.77% (468/2,967). Pooled results demonstrated that lower PNI was related to increased risk of postoperative mortality in type A AD patients [OR =0.77, 95% confidence interval (CI): 0.69-0.87, P<0.001]. As for the favourable diagnostic role of PNI for mortality risk in type A AD patients, pooled sensitivity and specificity were 0.808 (95% CI: 0.704-0.882) and 0.767 (95% CI: 0.647-0.856), with the LR+, LR- and FPR of 3.475 (95% CI: 2.251-5.364), 0.25 (95% CI: 0.16-0.391) and 0.233 (95% CI: 0.144-0.353). Besides, the DOR was 13.908 (95% CI: 6.892-28.07). Meanwhile, lower GNRI was associated with increased mortality risk in AD patients (OR =0.42, 95% CI: 0.24-0.74, P=0.002). CONCLUSIONS: Based on available evidence, it was manifested that PNI played a predictive role for postoperative mortality risk in type A AD patients and GNRI was associated with mortality risk of AD patients.