Association between Advanced lung cancer inflammation index and all- cause mortality in critically ill patients with sepsis: analysis of the MIMIC- IV database

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Abstract

Background This study aimed to explore the association between the advanced lung cancer inflammation (ALI) index and the risk of mortality in critically ill patients with sepsis. Methods This retrospective study included 6489 critically ill patients with sepsis from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. The participants were grouped into four groups according to the ALI index quartiles. The outcome was in-hospital mortality and ICU mortality. Cox proportional hazards regression analysis and restricted cubic spline regression was used to evaluate the association between the ALI index and clinical outcomes in critically ill patients with sepsis. Results A total of 6489 patients (59.1% male) were included in the study. The in-hospital and intensive care unit (ICU) mortality were 25.4% and 19.0%, respectively. Multivariate Cox proportional hazards analysis showed that the ALI index was independently associated with to all-cause mortality. After confounders adjusting, patients with an elevated ALI index had a significant association with hospital mortality (adjusted hazard ratio, 0.990; 95% confidence interval, 0.985–0.996; P < 0.001) and ICU mortality (adjusted hazard ratio, 0.991; 95% confidence interval, 0.985–0.997; P = 0.004). Restricted cubic splines revealed a non-linear association between ALI and all-cause mortality in sepsis patients. Conclusion Our study indicates that the ALI index has a significant association with hospital and ICU all-cause mortality in critically ill sepsis patients. However, further confirmation of these findings necessitates larger prospective studies.

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