Pan-Immune-Inflammation Value for Mortality Risk Stratification in Critically Ill Patients With Acute Ischemic...

Area of Science:

• Critical care medicine
• Neurology
• Inflammation research

Background:

• The pan-immune-inflammation value (PIV) is an emerging inflammatory biomarker.
• The prognostic significance of PIV in critical acute ischemic stroke (AIS) is not well understood.

Purpose of the Study:

• To investigate the association between PIV and all-cause mortality (ACM) in patients with critical AIS.
• To explore the prognostic role of PIV in predicting short-term and long-term mortality.

Main Methods:

• Retrospective cohort study of 710 ICU patients with AIS from the MIMIC-IV database.
• Multivariable Cox regression, restricted cubic splines, subgroup, and sensitivity analyses were employed.
• Evaluated associations with 90-day, 30-day, and 1-year ACM.

Main Results:

• An increase in PIV was independently associated with an 8% higher risk of 90-day ACM.
• A reverse L-shaped nonlinear correlation was observed, with a mortality threshold at PIV of 2987.61.
• Mortality was significantly higher in patients above this PIV threshold (52.7% vs. 28.3%).
• The association was stronger in patients without sepsis, and results were consistent across sensitivity analyses and for different mortality time points.

Conclusions:

• PIV demonstrates a reverse L-shaped relationship with both short- and long-term ACM in critical AIS.
• PIV can be utilized as a valuable tool for stratifying ACM risk in these patients.