Pan Immune Inflammation Value in Identifying Sepsis High-Inflammatory and Immunosuppressive Phenotype

BackgroundThe Pan-Immune Inflammation Value (PIV) is a potential indicator of immune phenotypes in sepsis.ObjectiveTo explore the association between PIV and clinically defined high-inflammatory and immunosuppressive phenotypes in sepsis and to evaluate its potential predictive value.MethodsClinical data from 156 patients with sepsis were retrospectively analyzed. Patients were divided into high inflammatory (n = 82) and immunosuppressive (n = 74) groups based on their immune status. The clinical data and laboratory indicators were compared between the two groups. Pearson's correlation analysis was used to determine the correlations between PIV and clinical indicators. Multiple logistic regression analysis was performed to identify the independent influencing factors. Receiver Operating Characteristic (ROC) analysis was used to evaluate the discriminatory ability of relevant indicators between the two sepsis phenotypes. Bootstrap method was used for validation, with 1000 repeated samples used to construct a calibration curve.ResultsThe APACHE II score was higher, and the levels of PCT, CRP, and PIV were elevated in the high-inflammatory group, whereas IgG levels were lower (P < 0.05). Pearson correlation analysis showed that APACHE II, PCT, and CRP were positively correlated with PIV, whereas IgG was negatively correlated with PIV (r = 0.760, 0.775, 0.770, and -0.765, respectively; P < 0.05). Multivariate logistic regression analysis identified APACHE II, PCT, CRP, IgG, and PIV as independent predictors of sepsis phenotypes (P < 0.05). ROC analysis showed that the combined detection of these indicators had higher AUC values than the individual indicators (Z = 4.447, 4.065, 4.414, 3.859, and 4.403, respectively; P < 0.05). The calibration curve demonstrated good agreement between the predicted and observed probabilities.ConclusionCombined detection of APACHE II, PCT, CRP, IgG, and PIV were associated with high-inflammatory and immunosuppressive phenotypes in sepsis and demonstrated moderate predictive value for phenotypic stratification. Further studies with dynamic monitoring and larger sample sizes are required to verify the clinical value of these indicators.