Inflammatory burden index as a predictor of mortality in septic patients: a retrospective study using the MIMIC-IV database
Abstract Purpose Previous studies have identified the Inflammatory Burden Index (IBI) as a potential predictor of mortality risk in inflammatory diseases. However, its relationship with mortality rates specifically in septic patients has not been thoroughly investigated. This study aimed to explore...
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BMC
2025-04-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-025-10936-0 |
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| author | Zhitao Zhong Mingyan Fan Lukai Lv Qiong Long Kefeng Li Ping Xu |
| author_facet | Zhitao Zhong Mingyan Fan Lukai Lv Qiong Long Kefeng Li Ping Xu |
| author_sort | Zhitao Zhong |
| collection | DOAJ |
| description | Abstract Purpose Previous studies have identified the Inflammatory Burden Index (IBI) as a potential predictor of mortality risk in inflammatory diseases. However, its relationship with mortality rates specifically in septic patients has not been thoroughly investigated. This study aimed to explore the association between IBI and mortality risk in patients with sepsis. Patients and methods We sourced clinical records of 1,828 septic patients from the Multiparameter Intelligent Monitoring in Intensive Care IV (MIMIC-IV 3.0) dataset, covering the period from 2008 to 2022. The primary endpoint was mortality within 28 days, with secondary endpoints including mortality during intensive care unit (ICU) stays and throughout hospitalization. Patients were categorized into quartiles based on their log-transformed Inflammatory Burden Index (LnIBI) levels. Binary logistic regression was utilized to examine the independent influence of IBI on mortality outcomes, adjusting for confounders. Additionally, the association between IBI and these outcomes was explored using restricted cubic splines and Kaplan-Meier analysis. Further comparison of receiver operating characteristic (ROC) curves was conducted to investigate the predictive performance. Results The study involved 1,828 septic patients, including 1,047 males. The all-cause mortality rates were 17.78% (325/1828) within 28 days, 17.34% (317/1828) during ICU stays, and 18.22% (333/1828) over the course of hospitalization. In the adjusted model, a positive correlation was found between LnIBI and mortality at 28 days (OR 1.093[1.014, 1.179], P = 0.021), during ICU stay (OR 1.106[1.025, 1.195], P = 0.01), and throughout hospitalization (OR 1.1[1.022, 1.187], P = 0.012). The analysis using restricted cubic splines showed a linear correlation between LnIBI and mortality risks. The areas under the curve (AUC) of LnIBI was larger than that of CRP (P < 0.05), and there were no significant differences between LnIBI and Neutrophil counts or Lymphocyte counts (P > 0.05). Kaplan-Meier plots revealed significantly lower survival rates for patients in the highest quartile of LnIBI (P < 0.001). Conclusion Elevated IBI values are significantly linked with higher mortality risks within 28 days, during ICU, and throughout the hospitalization period in septic patients. |
| format | Article |
| id | doaj-art-92f99aa2f6274406b3b28433684d6708 |
| institution | OA Journals |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
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| series | BMC Infectious Diseases |
| spelling | doaj-art-92f99aa2f6274406b3b28433684d67082025-08-20T02:24:26ZengBMCBMC Infectious Diseases1471-23342025-04-0125111010.1186/s12879-025-10936-0Inflammatory burden index as a predictor of mortality in septic patients: a retrospective study using the MIMIC-IV databaseZhitao Zhong0Mingyan Fan1Lukai Lv2Qiong Long3Kefeng Li4Ping Xu5Emergency Department, Zigong Fourth People’s HospitalEmergency Department, Zigong Fourth People’s HospitalEmergency Department, Zigong Fourth People’s HospitalLaboratory Department, Zigong Fourth People’s HospitalCenter for Artificial Intelligence Driven Drug Discovery, Faculty of Applied Sciences, Macao Polytechnic UniversityEmergency Department, Zigong Fourth People’s HospitalAbstract Purpose Previous studies have identified the Inflammatory Burden Index (IBI) as a potential predictor of mortality risk in inflammatory diseases. However, its relationship with mortality rates specifically in septic patients has not been thoroughly investigated. This study aimed to explore the association between IBI and mortality risk in patients with sepsis. Patients and methods We sourced clinical records of 1,828 septic patients from the Multiparameter Intelligent Monitoring in Intensive Care IV (MIMIC-IV 3.0) dataset, covering the period from 2008 to 2022. The primary endpoint was mortality within 28 days, with secondary endpoints including mortality during intensive care unit (ICU) stays and throughout hospitalization. Patients were categorized into quartiles based on their log-transformed Inflammatory Burden Index (LnIBI) levels. Binary logistic regression was utilized to examine the independent influence of IBI on mortality outcomes, adjusting for confounders. Additionally, the association between IBI and these outcomes was explored using restricted cubic splines and Kaplan-Meier analysis. Further comparison of receiver operating characteristic (ROC) curves was conducted to investigate the predictive performance. Results The study involved 1,828 septic patients, including 1,047 males. The all-cause mortality rates were 17.78% (325/1828) within 28 days, 17.34% (317/1828) during ICU stays, and 18.22% (333/1828) over the course of hospitalization. In the adjusted model, a positive correlation was found between LnIBI and mortality at 28 days (OR 1.093[1.014, 1.179], P = 0.021), during ICU stay (OR 1.106[1.025, 1.195], P = 0.01), and throughout hospitalization (OR 1.1[1.022, 1.187], P = 0.012). The analysis using restricted cubic splines showed a linear correlation between LnIBI and mortality risks. The areas under the curve (AUC) of LnIBI was larger than that of CRP (P < 0.05), and there were no significant differences between LnIBI and Neutrophil counts or Lymphocyte counts (P > 0.05). Kaplan-Meier plots revealed significantly lower survival rates for patients in the highest quartile of LnIBI (P < 0.001). Conclusion Elevated IBI values are significantly linked with higher mortality risks within 28 days, during ICU, and throughout the hospitalization period in septic patients.https://doi.org/10.1186/s12879-025-10936-0Inflammatory burden indexSepsisMortality riskMIMIC-IV database |
| spellingShingle | Zhitao Zhong Mingyan Fan Lukai Lv Qiong Long Kefeng Li Ping Xu Inflammatory burden index as a predictor of mortality in septic patients: a retrospective study using the MIMIC-IV database BMC Infectious Diseases Inflammatory burden index Sepsis Mortality risk MIMIC-IV database |
| title | Inflammatory burden index as a predictor of mortality in septic patients: a retrospective study using the MIMIC-IV database |
| title_full | Inflammatory burden index as a predictor of mortality in septic patients: a retrospective study using the MIMIC-IV database |
| title_fullStr | Inflammatory burden index as a predictor of mortality in septic patients: a retrospective study using the MIMIC-IV database |
| title_full_unstemmed | Inflammatory burden index as a predictor of mortality in septic patients: a retrospective study using the MIMIC-IV database |
| title_short | Inflammatory burden index as a predictor of mortality in septic patients: a retrospective study using the MIMIC-IV database |
| title_sort | inflammatory burden index as a predictor of mortality in septic patients a retrospective study using the mimic iv database |
| topic | Inflammatory burden index Sepsis Mortality risk MIMIC-IV database |
| url | https://doi.org/10.1186/s12879-025-10936-0 |
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