Prognostic value of inflammatory markers for in-hospital mortality in intensive care patients with acute ischemic stroke: a retrospective observational study based on MIMIC-IV
BackgroundAcute ischemic stroke (AIS) is a primary cause of death and disability worldwide. Four markers that can be readily determined from peripheral blood, namely, the systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and total bil...
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Frontiers Media S.A.
2023-06-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1174711/full |
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| author | Xuyang Hu Xuyang Hu Jiaru Liang Wenjian Hao Jiaqi Zhou Yuling Gao Xiaoyang Gong Yong Liu Yong Liu |
| author_facet | Xuyang Hu Xuyang Hu Jiaru Liang Wenjian Hao Jiaqi Zhou Yuling Gao Xiaoyang Gong Yong Liu Yong Liu |
| author_sort | Xuyang Hu |
| collection | DOAJ |
| description | BackgroundAcute ischemic stroke (AIS) is a primary cause of death and disability worldwide. Four markers that can be readily determined from peripheral blood, namely, the systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and total bilirubin, were measured in this study. We examined the relationship between the SII and in-hospital mortality after AIS and evaluated which of the above four indicators was most accurate for predicting in-hospital mortality after AIS.MethodsWe selected patients from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database who were aged >18 years and who were diagnosed with AIS on admission. We collected the patients’ baseline characteristics, including various clinical and laboratory data. To investigate the relationship between the SII and in-hospital mortality in patients with AIS, we employed the generalized additive model (GAM). Differences in in-hospital mortality between the groups were summarized by the Kaplan–Meier survival analysis and the log-rank test. The receiver operating characteristic (ROC) curve analysis was used to assess the accuracy of the four indicators (SII, NLR, PLR, and total bilirubin) for predicting in-hospital mortality in patients with AIS.ResultsThe study included 463 patients, and the in-hospital mortality rate was 12.31%. The GAM analysis showed a positive correlation between the SII and in-hospital mortality in patients with AIS, but the correlation was not linear. Unadjusted Cox regression identified a link between a high SII and an increased probability of in-hospital mortality. We also found that patients with an SII of >1,232 (Q2 group) had a considerably higher chance of in-hospital mortality than those with a low SII (Q1 group). The Kaplan–Meier analysis demonstrated that patients with an elevated SII had a significantly lower chance of surviving their hospital stay than those with a low SII. According to the results of the ROC curve analysis, the in-hospital mortality of patients with AIS predicted by the SII had an area under the ROC curve of 0.65, which revealed that the SII had a better discriminative ability than the NLR, PLR, and total bilirubin.ConclusionThe in-hospital mortality of patients with AIS and the SII were positively correlated, but not linearly. A high SII was associated with a worse prognosis in patients with AIS. The SII had a modest level of discrimination for forecasting in-hospital mortality. The SII was slightly better than the NLR and significantly better than the PLR and total bilirubin for predicting in-hospital mortality in patients with AIS. |
| first_indexed | 2024-03-13T06:47:15Z |
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| id | doaj.art-51a57c157f5e41818bec6029d8ef1b49 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-13T06:47:15Z |
| publishDate | 2023-06-01 |
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| series | Frontiers in Neurology |
| spelling | doaj.art-51a57c157f5e41818bec6029d8ef1b492023-06-08T05:12:49ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-06-011410.3389/fneur.2023.11747111174711Prognostic value of inflammatory markers for in-hospital mortality in intensive care patients with acute ischemic stroke: a retrospective observational study based on MIMIC-IVXuyang Hu0Xuyang Hu1Jiaru Liang2Wenjian Hao3Jiaqi Zhou4Yuling Gao5Xiaoyang Gong6Yong Liu7Yong Liu8Department of Rehabilitation Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, ChinaInstitute (College) of Integrative Medicine, Dalian Medical University, Dalian, ChinaInstitute (College) of Integrative Medicine, Dalian Medical University, Dalian, ChinaInstitute (College) of Integrative Medicine, Dalian Medical University, Dalian, ChinaDepartment of Rehabilitation Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, ChinaDepartment of Rehabilitation Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, ChinaDepartment of Rehabilitation Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, ChinaDepartment of Rehabilitation Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, ChinaInstitute (College) of Integrative Medicine, Dalian Medical University, Dalian, ChinaBackgroundAcute ischemic stroke (AIS) is a primary cause of death and disability worldwide. Four markers that can be readily determined from peripheral blood, namely, the systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and total bilirubin, were measured in this study. We examined the relationship between the SII and in-hospital mortality after AIS and evaluated which of the above four indicators was most accurate for predicting in-hospital mortality after AIS.MethodsWe selected patients from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database who were aged >18 years and who were diagnosed with AIS on admission. We collected the patients’ baseline characteristics, including various clinical and laboratory data. To investigate the relationship between the SII and in-hospital mortality in patients with AIS, we employed the generalized additive model (GAM). Differences in in-hospital mortality between the groups were summarized by the Kaplan–Meier survival analysis and the log-rank test. The receiver operating characteristic (ROC) curve analysis was used to assess the accuracy of the four indicators (SII, NLR, PLR, and total bilirubin) for predicting in-hospital mortality in patients with AIS.ResultsThe study included 463 patients, and the in-hospital mortality rate was 12.31%. The GAM analysis showed a positive correlation between the SII and in-hospital mortality in patients with AIS, but the correlation was not linear. Unadjusted Cox regression identified a link between a high SII and an increased probability of in-hospital mortality. We also found that patients with an SII of >1,232 (Q2 group) had a considerably higher chance of in-hospital mortality than those with a low SII (Q1 group). The Kaplan–Meier analysis demonstrated that patients with an elevated SII had a significantly lower chance of surviving their hospital stay than those with a low SII. According to the results of the ROC curve analysis, the in-hospital mortality of patients with AIS predicted by the SII had an area under the ROC curve of 0.65, which revealed that the SII had a better discriminative ability than the NLR, PLR, and total bilirubin.ConclusionThe in-hospital mortality of patients with AIS and the SII were positively correlated, but not linearly. A high SII was associated with a worse prognosis in patients with AIS. The SII had a modest level of discrimination for forecasting in-hospital mortality. The SII was slightly better than the NLR and significantly better than the PLR and total bilirubin for predicting in-hospital mortality in patients with AIS.https://www.frontiersin.org/articles/10.3389/fneur.2023.1174711/fullacute ischemic strokein-hospital mortalityMIMIC-IVSIIinflammatory markerpredictor |
| spellingShingle | Xuyang Hu Xuyang Hu Jiaru Liang Wenjian Hao Jiaqi Zhou Yuling Gao Xiaoyang Gong Yong Liu Yong Liu Prognostic value of inflammatory markers for in-hospital mortality in intensive care patients with acute ischemic stroke: a retrospective observational study based on MIMIC-IV Frontiers in Neurology acute ischemic stroke in-hospital mortality MIMIC-IV SII inflammatory marker predictor |
| title | Prognostic value of inflammatory markers for in-hospital mortality in intensive care patients with acute ischemic stroke: a retrospective observational study based on MIMIC-IV |
| title_full | Prognostic value of inflammatory markers for in-hospital mortality in intensive care patients with acute ischemic stroke: a retrospective observational study based on MIMIC-IV |
| title_fullStr | Prognostic value of inflammatory markers for in-hospital mortality in intensive care patients with acute ischemic stroke: a retrospective observational study based on MIMIC-IV |
| title_full_unstemmed | Prognostic value of inflammatory markers for in-hospital mortality in intensive care patients with acute ischemic stroke: a retrospective observational study based on MIMIC-IV |
| title_short | Prognostic value of inflammatory markers for in-hospital mortality in intensive care patients with acute ischemic stroke: a retrospective observational study based on MIMIC-IV |
| title_sort | prognostic value of inflammatory markers for in hospital mortality in intensive care patients with acute ischemic stroke a retrospective observational study based on mimic iv |
| topic | acute ischemic stroke in-hospital mortality MIMIC-IV SII inflammatory marker predictor |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1174711/full |
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