慢性阻塞性肺疾病危重患者泛免疫炎症值与住院死亡率的关系：一项观察性研究

IF 3.5 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Respiratory medicine Pub Date : 2025-06-14 DOI:10.1016/j.rmed.2025.108213

Mohan Giri , Anju Puri , Yi Chen , Yan Liu , Shuliang Guo

{"title":"慢性阻塞性肺疾病危重患者泛免疫炎症值与住院死亡率的关系：一项观察性研究","authors":"Mohan Giri , Anju Puri , Yi Chen , Yan Liu , Shuliang Guo","doi":"10.1016/j.rmed.2025.108213","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to examine the relationship between the pan-immune inflammation value (PIV) and mortality in critically ill patients with chronic obstructive pulmonary disease (COPD), highlighting its potential as a prognostic tool for this high-risk group.</div></div><div><h3>Methods</h3><div>This retrospective cohort study utilized data from the MIMIC-IV 2.2 database. Participants were stratified into tertiles based on their PIV levels, with the primary endpoint being in-hospital mortality. Cox proportional hazards regression models were used to analyze the association between PIV and mortality, and Kaplan-Meier survival curves illustrated survival differences among PIV tertiles. Subgroup analyses and interaction tests ensured the robustness of the findings.</div></div><div><h3>Results</h3><div>A total of 3259 critically ill COPD patients were included. The in-hospital and 90-day mortality rates were 15 % and 27.6 %, respectively. Multivariate analysis showed that higher PIV levels were significantly associated with increased in-hospital (HR: 1.08, 95 % CI: 1.02–1.14, P = 0.012) and 90-day mortality (HR: 1.16, 95 % CI: 1.11–1.21, P < 0.001). Patients in the highest tertile of PIV (T3) had a significantly higher risk of mortality compared to those in the lowest tertile (T1). The trend test across tertiles demonstrated a positive association between PIV and mortality risk in all models (P for trend <0.001). Subgroup analyses revealed no significant effect modification except for gender and liver disease.</div></div><div><h3>Conclusion</h3><div>Elevated baseline PIV was independently associated with higher mortality risks in critically ill COPD patients, suggesting its potential as a simple, reliable, and cost-effective prognostic indicator for high-risk patients.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"245 ","pages":"Article 108213"},"PeriodicalIF":3.5000,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Association between Pan-immune-inflammation value and in-hospital mortality in critically ill patients with Chronic obstructive pulmonary disease: An observational study\",\"authors\":\"Mohan Giri , Anju Puri , Yi Chen , Yan Liu , Shuliang Guo\",\"doi\":\"10.1016/j.rmed.2025.108213\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>This study aimed to examine the relationship between the pan-immune inflammation value (PIV) and mortality in critically ill patients with chronic obstructive pulmonary disease (COPD), highlighting its potential as a prognostic tool for this high-risk group.</div></div><div><h3>Methods</h3><div>This retrospective cohort study utilized data from the MIMIC-IV 2.2 database. Participants were stratified into tertiles based on their PIV levels, with the primary endpoint being in-hospital mortality. Cox proportional hazards regression models were used to analyze the association between PIV and mortality, and Kaplan-Meier survival curves illustrated survival differences among PIV tertiles. Subgroup analyses and interaction tests ensured the robustness of the findings.</div></div><div><h3>Results</h3><div>A total of 3259 critically ill COPD patients were included. The in-hospital and 90-day mortality rates were 15 % and 27.6 %, respectively. Multivariate analysis showed that higher PIV levels were significantly associated with increased in-hospital (HR: 1.08, 95 % CI: 1.02–1.14, P = 0.012) and 90-day mortality (HR: 1.16, 95 % CI: 1.11–1.21, P < 0.001). Patients in the highest tertile of PIV (T3) had a significantly higher risk of mortality compared to those in the lowest tertile (T1). The trend test across tertiles demonstrated a positive association between PIV and mortality risk in all models (P for trend <0.001). Subgroup analyses revealed no significant effect modification except for gender and liver disease.</div></div><div><h3>Conclusion</h3><div>Elevated baseline PIV was independently associated with higher mortality risks in critically ill COPD patients, suggesting its potential as a simple, reliable, and cost-effective prognostic indicator for high-risk patients.</div></div>\",\"PeriodicalId\":21057,\"journal\":{\"name\":\"Respiratory medicine\",\"volume\":\"245 \",\"pages\":\"Article 108213\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2025-06-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Respiratory medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0954611125002768\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Respiratory medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0954611125002768","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

摘要

本研究旨在探讨慢性阻塞性肺疾病（COPD）危重患者的泛免疫炎症值（PIV）与死亡率之间的关系，强调其作为这一高危人群预后工具的潜力。方法采用回顾性队列研究，数据来自MIMIC-IV 2.2数据库。参与者根据他们的PIV水平被分层，主要终点是住院死亡率。采用Cox比例风险回归模型分析PIV与死亡率之间的关系，Kaplan-Meier生存曲线说明PIV分位数之间的生存差异。亚组分析和相互作用测试确保了研究结果的稳健性。结果共纳入3259例COPD危重患者。住院死亡率和90天死亡率分别为15%和27.6%。多因素分析显示，较高的PIV水平与住院率（HR: 1.08, 95% CI: 1.02-1.14, P = 0.012）和90天死亡率(HR: 1.16, 95% CI: 1.11-1.21, P <；0.001)。PIV最高分位数（T3）患者的死亡风险明显高于最低分位数（T1）患者。趋势检验表明，在所有模型中，PIV与死亡风险呈正相关（P代表趋势<；0.001）。亚组分析显示，除性别和肝脏疾病外，没有显著的影响改变。结论基线PIV升高与危重COPD患者较高的死亡风险独立相关，提示PIV可作为高危患者简单、可靠、经济的预后指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Association between Pan-immune-inflammation value and in-hospital mortality in critically ill patients with Chronic obstructive pulmonary disease: An observational study

Objective

This study aimed to examine the relationship between the pan-immune inflammation value (PIV) and mortality in critically ill patients with chronic obstructive pulmonary disease (COPD), highlighting its potential as a prognostic tool for this high-risk group.

Methods

This retrospective cohort study utilized data from the MIMIC-IV 2.2 database. Participants were stratified into tertiles based on their PIV levels, with the primary endpoint being in-hospital mortality. Cox proportional hazards regression models were used to analyze the association between PIV and mortality, and Kaplan-Meier survival curves illustrated survival differences among PIV tertiles. Subgroup analyses and interaction tests ensured the robustness of the findings.

Results

A total of 3259 critically ill COPD patients were included. The in-hospital and 90-day mortality rates were 15 % and 27.6 %, respectively. Multivariate analysis showed that higher PIV levels were significantly associated with increased in-hospital (HR: 1.08, 95 % CI: 1.02–1.14, P = 0.012) and 90-day mortality (HR: 1.16, 95 % CI: 1.11–1.21, P < 0.001). Patients in the highest tertile of PIV (T3) had a significantly higher risk of mortality compared to those in the lowest tertile (T1). The trend test across tertiles demonstrated a positive association between PIV and mortality risk in all models (P for trend <0.001). Subgroup analyses revealed no significant effect modification except for gender and liver disease.

Conclusion

Elevated baseline PIV was independently associated with higher mortality risks in critically ill COPD patients, suggesting its potential as a simple, reliable, and cost-effective prognostic indicator for high-risk patients.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Respiratory medicine 医学-呼吸系统

CiteScore

7.50

自引率

0.00%

发文量

199

审稿时长

38 days

期刊介绍： Respiratory Medicine is an internationally-renowned journal devoted to the rapid publication of clinically-relevant respiratory medicine research. It combines cutting-edge original research with state-of-the-art reviews dealing with all aspects of respiratory diseases and therapeutic interventions. Topics include adult and paediatric medicine, epidemiology, immunology and cell biology, physiology, occupational disorders, and the role of allergens and pollutants. Respiratory Medicine is increasingly the journal of choice for publication of phased trial work, commenting on effectiveness, dosage and methods of action.