Association of PIV value with early mortality in ICU patients with sepsis-associated acute kidney injury from the MIMIC IV database
Abstract Sepsis is a severe systemic inflammatory response, and sepsis-associated acute kidney injury (SA-AKI) is one of its most common complications. The pan-immune inflammation value (PIV), a novel inflammatory index, is designed to comprehensively reflect the status of systemic immune and inflam...
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Nature Portfolio
2025-04-01
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| Online Access: | https://doi.org/10.1038/s41598-025-96320-z |
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| author | Heping Xu Xinyi Cai Huan Niu Xiongwei Cai Ping He Yanhong Ouyang |
| author_facet | Heping Xu Xinyi Cai Huan Niu Xiongwei Cai Ping He Yanhong Ouyang |
| author_sort | Heping Xu |
| collection | DOAJ |
| description | Abstract Sepsis is a severe systemic inflammatory response, and sepsis-associated acute kidney injury (SA-AKI) is one of its most common complications. The pan-immune inflammation value (PIV), a novel inflammatory index, is designed to comprehensively reflect the status of systemic immune and inflammatory responses. However, the relationship between PIV and short-term clinical outcomes in SA-AKI patients remains unclear. This study was a retrospective analysis of SA-AKI patients from the MIMIC-IV database. The Boruta algorithm was used to identify key features predicting short-term mortality in SA-AKI patients. The relationships between ln (PIV) and all-cause mortality at 28 days and 90 days were assessed via multivariate Cox proportional hazards regression, subgroup analysis, sensitivity analysis, restricted cubic spline (RCS) modelling, and Kaplan‒Meier (K–M) survival analysis. A total of 4369 patients were included in the study, of whom 57.0% were male. Boruta analysis indicated that ln (PIV) was an important clinical feature. The results of multivariable Cox regression analysis revealed a positive correlation between ln (PIV) and mortality risk at both 28 days and 90 days (HR [95% CI] = 1.057 [1.009, 1.106], P = 0.019; HR [95% CI] = 1.075 [1.032, 1.120], P < 0.001). The RCS model revealed a nonlinear relationship between ln (PIV) and mortality at 28 and 90 days, with a critical threshold of 6.72. Above this threshold, a higher ln (PIV) was associated with increased mortality risk at both time points; sensitivity analyses confirmed that this association remained significant after specific patients were excluded. Subgroup analyses revealed that ln (PIV) significantly affected short-term mortality in diabetic patients (P < 0.05). Ln (PIV) is closely associated with short-term mortality in ICU patients with SA-AKI, suggesting its potential application in early risk assessment and clinical intervention. |
| format | Article |
| id | doaj-art-a1c2bebde4614315b838c5cf29689db2 |
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| issn | 2045-2322 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-a1c2bebde4614315b838c5cf29689db22025-08-20T02:08:08ZengNature PortfolioScientific Reports2045-23222025-04-0115111110.1038/s41598-025-96320-zAssociation of PIV value with early mortality in ICU patients with sepsis-associated acute kidney injury from the MIMIC IV databaseHeping Xu0Xinyi Cai1Huan Niu2Xiongwei Cai3Ping He4Yanhong Ouyang5Department of Emergency Medicine, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical UniversityDepartment of Emergency Medicine, Hainan Affiliated Hospital of Hainan Medical UniversityDepartment of Emergency Medicine, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical UniversityDepartment of Emergency Medicine, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical UniversityDepartment of Emergency Medicine, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical UniversityDepartment of Emergency Medicine, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical UniversityAbstract Sepsis is a severe systemic inflammatory response, and sepsis-associated acute kidney injury (SA-AKI) is one of its most common complications. The pan-immune inflammation value (PIV), a novel inflammatory index, is designed to comprehensively reflect the status of systemic immune and inflammatory responses. However, the relationship between PIV and short-term clinical outcomes in SA-AKI patients remains unclear. This study was a retrospective analysis of SA-AKI patients from the MIMIC-IV database. The Boruta algorithm was used to identify key features predicting short-term mortality in SA-AKI patients. The relationships between ln (PIV) and all-cause mortality at 28 days and 90 days were assessed via multivariate Cox proportional hazards regression, subgroup analysis, sensitivity analysis, restricted cubic spline (RCS) modelling, and Kaplan‒Meier (K–M) survival analysis. A total of 4369 patients were included in the study, of whom 57.0% were male. Boruta analysis indicated that ln (PIV) was an important clinical feature. The results of multivariable Cox regression analysis revealed a positive correlation between ln (PIV) and mortality risk at both 28 days and 90 days (HR [95% CI] = 1.057 [1.009, 1.106], P = 0.019; HR [95% CI] = 1.075 [1.032, 1.120], P < 0.001). The RCS model revealed a nonlinear relationship between ln (PIV) and mortality at 28 and 90 days, with a critical threshold of 6.72. Above this threshold, a higher ln (PIV) was associated with increased mortality risk at both time points; sensitivity analyses confirmed that this association remained significant after specific patients were excluded. Subgroup analyses revealed that ln (PIV) significantly affected short-term mortality in diabetic patients (P < 0.05). Ln (PIV) is closely associated with short-term mortality in ICU patients with SA-AKI, suggesting its potential application in early risk assessment and clinical intervention.https://doi.org/10.1038/s41598-025-96320-zPan-immune-inflammation valueAcute kidney injurySepsisMortalityMIMIC-IV |
| spellingShingle | Heping Xu Xinyi Cai Huan Niu Xiongwei Cai Ping He Yanhong Ouyang Association of PIV value with early mortality in ICU patients with sepsis-associated acute kidney injury from the MIMIC IV database Scientific Reports Pan-immune-inflammation value Acute kidney injury Sepsis Mortality MIMIC-IV |
| title | Association of PIV value with early mortality in ICU patients with sepsis-associated acute kidney injury from the MIMIC IV database |
| title_full | Association of PIV value with early mortality in ICU patients with sepsis-associated acute kidney injury from the MIMIC IV database |
| title_fullStr | Association of PIV value with early mortality in ICU patients with sepsis-associated acute kidney injury from the MIMIC IV database |
| title_full_unstemmed | Association of PIV value with early mortality in ICU patients with sepsis-associated acute kidney injury from the MIMIC IV database |
| title_short | Association of PIV value with early mortality in ICU patients with sepsis-associated acute kidney injury from the MIMIC IV database |
| title_sort | association of piv value with early mortality in icu patients with sepsis associated acute kidney injury from the mimic iv database |
| topic | Pan-immune-inflammation value Acute kidney injury Sepsis Mortality MIMIC-IV |
| url | https://doi.org/10.1038/s41598-025-96320-z |
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