Association between Pan-immune-inflammation value and in-hospital mortality in critically ill patients with Chronic obstructive pulmonary disease: An observational study

Abstract

Objective: This study aimed to examine the relationship between the pan-immune inflammation value (PIV) and mortality in critically ill patients with chronic obstructive pulmonary disease (COPD), highlighting its potential as a prognostic tool for this high-risk group.

Methods: This retrospective cohort study utilized data from the MIMIC-IV 2.2 database. Participants were stratified into tertiles based on their PIV levels, with the primary endpoint being in-hospital mortality. Cox proportional hazards regression models were used to analyze the association between PIV and mortality, and Kaplan-Meier survival curves illustrated survival differences among PIV tertiles. Subgroup analyses and interaction tests ensured the robustness of the findings.

Results: A total of 3259 critically ill COPD patients were included. The in-hospital and 90-day mortality rates were 15 % and 27.6 %, respectively. Multivariate analysis showed that higher PIV levels were significantly associated with increased in-hospital (HR: 1.08, 95 % CI: 1.02-1.14, P = 0.012) and 90-day mortality (HR: 1.16, 95 % CI: 1.11-1.21, P < 0.001). Patients in the highest tertile of PIV (T3) had a significantly higher risk of mortality compared to those in the lowest tertile (T1). The trend test across tertiles demonstrated a positive association between PIV and mortality risk in all models (P for trend <0.001). Subgroup analyses revealed no significant effect modification except for gender and liver disease.

Conclusion: Elevated baseline PIV was independently associated with higher mortality risks in critically ill COPD patients, suggesting its potential as a simple, reliable, and cost-effective prognostic indicator for high-risk patients.

Keywords: Chronic obstructive pulmonary disease; Critically ill; Inflammation; MIMIC-IV database; Mortality; Pan-immune inflammation value.