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. 2024 Jun 14;7(3):350-359.
doi: 10.1002/agm2.12334. eCollection 2024 Jun.

Association between advanced lung cancer inflammation index and in-hospital mortality in ICU patients with community-acquired pneumonia: A retrospective analysis of the MIMIC-IV database

Feng Yang  1 , Lianjun Gao  1 , Cuiping Xu  1 , Qimin Wang  1 , Wei Gao  1
Affiliations

Association between advanced lung cancer inflammation index and in-hospital mortality in ICU patients with community-acquired pneumonia: A retrospective analysis of the MIMIC-IV database

Feng Yang et al. Aging Med (Milton). .

Abstract

Objective: The objective of the present study was to explore the correlation between the advanced lung cancer inflammation index (ALI) and in-hospital mortality among patients diagnosed with community-acquired pneumonia (CAP).

Methods: Data from the Medical Information Mart for Intensive Care-IV database were adopted to analyze the in-hospital mortality of ICU patients with CAP. Upon admission to the ICU, fundamental data including vital signs, critical illness scores, comorbidities, and laboratory results, were collected. The in-hospital mortality of all CAP patients was documented. Multivariate logistic regression (MLR) models and restricted cubic spline (RCS) analysis together with subgroup analyses were conducted.

Results: This study includes 311 CAP individuals, involving 218 survivors as well as 93 nonsurvivors. The participants had an average age of 63.57 years, and the females accounted for approximately 45.33%. The in-hospital mortality was documented to be 29.90%. MLR analysis found that ALI was identified as an independent predictor for in-hospital mortality among patients with CAP solely in the Q1 group with ALI ≤ 39.38 (HR: 2.227, 95% CI: 1.026-4.831, P = 0.043). RCS analysis showed a nonlinear relationship between the ALI and in-hospital mortality, with a turning point at 81, and on the left side of the inflection point, a negative correlation was observed between ALI and in-hospital mortality (HR: 0.984, 95% CI: 0.975-0.994, P = 0.002). The subgroup with high blood pressure showed significant interaction with the ALI.

Conclusion: The present study demonstrated a nonlinear correlation of the ALI with in-hospital mortality among individuals with CAP. Additional confirmation of these findings requires conducting larger prospective investigations.

Keywords: MIMIC‐IV database; advanced lung cancer inflammation index; community‐acquired pneumonia; in‐hospital mortality; nonlinear relationship.

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Conflict of interest statement

None declared.

Figures

FIGURE 1
FIGURE 1
Flowchart of participants in the study. CAP, community‐acquired pneumonia; ICU, intensive care unit; MIMIC‐IV, medical information mart for intensive care.
FIGURE 2
FIGURE 2
ROCs curve for in‐hospital survival.
FIGURE 3
FIGURE 3
The relationship of ALI with in‐hospital mortality.
See this image and copyright information in PMC

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