Association between Pan-immune-inflammation value and in-hospital mortality in critically ill patients with Chronic...

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.

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.

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.

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.