The endothelial activation and stress index as a risk factor for all-cause mortality in patients with anemia: a nationwide retrospective cross-sectional study
Objectives Limited evidence exists on the association between the endothelial activation and stress index (EASIX) and mortality in anemia patients. This national cross-sectional study investigated the relationship between the EASIX and all-cause mortality in anemic individuals and assessed its clini...
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Taylor & Francis Group
2025-12-01
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| Series: | Hematology |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/16078454.2025.2542634 |
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| author | Liangliang Wu Gaiying Dong Tingting Wu Xiaofan Gu Yuping Zhang Shunqing Wang |
| author_facet | Liangliang Wu Gaiying Dong Tingting Wu Xiaofan Gu Yuping Zhang Shunqing Wang |
| author_sort | Liangliang Wu |
| collection | DOAJ |
| description | Objectives Limited evidence exists on the association between the endothelial activation and stress index (EASIX) and mortality in anemia patients. This national cross-sectional study investigated the relationship between the EASIX and all-cause mortality in anemic individuals and assessed its clinical utility.Methods We analyzed data from 2954 anemia patients in the NHANES (2003–2016), with mortality follow-up through December 31, 2019. Restricted cubic spline (RCS) analysis evaluated the EASIX-mortality association. The optimal EASIX cutoff value for survival was determined using the maximally selected rank statistics method (MSRSM). Weighted multivariate Cox regression and time-dependent receiver operating characteristic (ROC) curve analysis assessed EASIX’s predictive performance.Results Over a median 81-month follow-up, 840 deaths (28.4%) occurred. RCS regression analysis revealed that higher EASIX scores were associated with increased all-cause mortality. Patients were categorized into lower (≤0.72) and higher (>0.72) EASIX groups based on the MSRM results. According to the multivariate-adjusted model, compared with the lower EASIX group, the higher EASIX group demonstrated an HR of 1.42 for all-cause mortality. Time-dependent ROC analysis revealed AUCs of 0.75, 0.75, 0.76, and 0.78 for 1-, 3-, 5-, and 10-year all-cause mortality, respectively.Conclusions An elevated EASIX score, derived from routine clinical parameters, is independently associated with increased all-cause mortality in anemic patients. These findings suggest that the EASIX may serve as a valuable prognostic biomarker for risk stratification and could assist in guiding the management of anemia. Further prospective cohort studies are needed to confirm its prognostic value in this population. |
| format | Article |
| id | doaj-art-b34b2be613ec4811a2ebe633374edd76 |
| institution | Kabale University |
| issn | 1607-8454 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Hematology |
| spelling | doaj-art-b34b2be613ec4811a2ebe633374edd762025-08-20T04:02:08ZengTaylor & Francis GroupHematology1607-84542025-12-0130110.1080/16078454.2025.2542634The endothelial activation and stress index as a risk factor for all-cause mortality in patients with anemia: a nationwide retrospective cross-sectional studyLiangliang Wu0Gaiying Dong1Tingting Wu2Xiaofan Gu3Yuping Zhang4Shunqing Wang5Department of Hematology, Guangzhou First People's Hospital, South China University of Technology, Guangzhou, People’s Republic of ChinaDepartment of Medical Ultrasound, Guangzhou First People's Hospital, South China University of Technology, Guangzhou, People’s Republic of ChinaDepartment of Thoracic Surgery, Anhui Public Health Clinical Center, the First Affiliated Hospital of Anhui University North District, Hefei, People’s Republic of ChinaDepartment of Laboratory Medicine, Guangzhou First People's Hospital, South China University of Technology, Guangzhou, People’s Republic of ChinaDepartment of Hematology, Guangzhou First People's Hospital, South China University of Technology, Guangzhou, People’s Republic of ChinaDepartment of Hematology, Guangzhou First People's Hospital, South China University of Technology, Guangzhou, People’s Republic of ChinaObjectives Limited evidence exists on the association between the endothelial activation and stress index (EASIX) and mortality in anemia patients. This national cross-sectional study investigated the relationship between the EASIX and all-cause mortality in anemic individuals and assessed its clinical utility.Methods We analyzed data from 2954 anemia patients in the NHANES (2003–2016), with mortality follow-up through December 31, 2019. Restricted cubic spline (RCS) analysis evaluated the EASIX-mortality association. The optimal EASIX cutoff value for survival was determined using the maximally selected rank statistics method (MSRSM). Weighted multivariate Cox regression and time-dependent receiver operating characteristic (ROC) curve analysis assessed EASIX’s predictive performance.Results Over a median 81-month follow-up, 840 deaths (28.4%) occurred. RCS regression analysis revealed that higher EASIX scores were associated with increased all-cause mortality. Patients were categorized into lower (≤0.72) and higher (>0.72) EASIX groups based on the MSRM results. According to the multivariate-adjusted model, compared with the lower EASIX group, the higher EASIX group demonstrated an HR of 1.42 for all-cause mortality. Time-dependent ROC analysis revealed AUCs of 0.75, 0.75, 0.76, and 0.78 for 1-, 3-, 5-, and 10-year all-cause mortality, respectively.Conclusions An elevated EASIX score, derived from routine clinical parameters, is independently associated with increased all-cause mortality in anemic patients. These findings suggest that the EASIX may serve as a valuable prognostic biomarker for risk stratification and could assist in guiding the management of anemia. Further prospective cohort studies are needed to confirm its prognostic value in this population.https://www.tandfonline.com/doi/10.1080/16078454.2025.2542634Anemiaendothelial activation and stress indexmortalityrisk factor |
| spellingShingle | Liangliang Wu Gaiying Dong Tingting Wu Xiaofan Gu Yuping Zhang Shunqing Wang The endothelial activation and stress index as a risk factor for all-cause mortality in patients with anemia: a nationwide retrospective cross-sectional study Hematology Anemia endothelial activation and stress index mortality risk factor |
| title | The endothelial activation and stress index as a risk factor for all-cause mortality in patients with anemia: a nationwide retrospective cross-sectional study |
| title_full | The endothelial activation and stress index as a risk factor for all-cause mortality in patients with anemia: a nationwide retrospective cross-sectional study |
| title_fullStr | The endothelial activation and stress index as a risk factor for all-cause mortality in patients with anemia: a nationwide retrospective cross-sectional study |
| title_full_unstemmed | The endothelial activation and stress index as a risk factor for all-cause mortality in patients with anemia: a nationwide retrospective cross-sectional study |
| title_short | The endothelial activation and stress index as a risk factor for all-cause mortality in patients with anemia: a nationwide retrospective cross-sectional study |
| title_sort | endothelial activation and stress index as a risk factor for all cause mortality in patients with anemia a nationwide retrospective cross sectional study |
| topic | Anemia endothelial activation and stress index mortality risk factor |
| url | https://www.tandfonline.com/doi/10.1080/16078454.2025.2542634 |
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