Association of Gustave Roussy immune score and the risk of in-hospital mortality in patients with acute respiratory distress syndrome: A retrospective cohort study from MIMIC-IV database.

Background: There has been a lack of studies to describe the relationship between Gustave Roussy immune score (GRIm-s) and the risk of in-hospital mortality in patients with acute respiratory distress syndrome (ARDS) so far. This study aimed to investigate the relationship between GRIm-s and hospital mortality in patients with ARDS and to compare the predictive ability of GRIm-s with common scoring systems for predicting mortality risk based on MIMIC-IV database.

Methods: GRIm-s was calculated based on albumin, neutrophil-to-lymphocyte ratio (NLR) and lactate dehydrogenase (LDH). The univariate and multivariate logistic regression analysis were used to explore association between GRIm-s and in-hospital mortality, with odds ratio (OR) and 95 % confidence intervals (CIs). The receiver operator characteristic (ROC) analysis was performed to verity the predictive power and the enhancement the predictive power of GRIm-s to NLR and sequential organ failure assessment (SOFA), simplified acute physiology score II (SAPSII) and confusion, uremia, respiratory rate, blood pressure, age ≥65 years (CURB-65), with area under the curve (AUC) and 95 %CI.

Results: Totally 1238 eligible ARDS patients were included with the in-hospital mortality was 34.25 %. High GRIm-s was associated with higher risk of in-hospital mortality. The predictive value of GRIm-s was superior to NLR. GRIm-s can significantly improve the predictive power of a single score prediction system including SOFA, SAPSII, and CURB-65.

Conclusions: High GRIm-s was associated with high risk of in-hospital mortality in ARDS patients. GRIm-s has a good predictive ability for the prognosis of ARDS patients.