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Associations between Global Immune-Nutrition-Inflammation Index and Risk of Mortality in Intensive Care Unit Patients
Guiyuan Li1, Minxing Wang2, Shenghua Zhuo3
1Department of Urology, Zhuhai People's Hospital (Zhuhai Clinical Medical College of Jinan University), Zhuhai, China.
Purpose:
This retrospective study aimed to evaluate the association between the newly developed Global Immune-Nutrition-Inflammation (GINI) index and the risk of all-cause mortality among patients admitted to the intensive care unit (ICU).
Methods:
Data were extracted from the Medical Information Mart for Intensive Care IV version 3.0 (MIMIC-IV-3.0) database. Associations between the GINI index and all-cause mortality were assessed using Kaplan-Meier survival curves and multivariate weighted Cox regression models. Additionally, restricted cubic spline (RCS) analyses were performed to explore potential non-linear relationships between the GINI index and hazard ratios (HRs). Subgroup analyses were conducted to evaluate possible interactions between the GINI index and selected clinical features.
Results:
A total of 970 patients were included, of whom 11.75% (N = 114) experienced all-cause mortality. A significant association was observed between a higher GINI index and increased risk of all-cause mortality. This association remained consistent when the GINI index was treated as a continuous variable (HR = 1.12; P = 0.03) and when categorized into groups (Group 2 vs. Group 1: HR = 1.97; P = 0.02; Group 3 vs. Group 1: HR = 2.17; P = 0.01). The RCS analysis supported a linear, rather than a non-linear, relationship between the GINI index and all-cause mortality (P > 0.05 for non-linearity).
Conclusions:
The GINI index is associated with elevated all-cause mortality risk among ICU patients and may serve as a promising candidate for mortality risk stratification, which highlights the potential benefit of timely targeted intervention.
