Systemic immune-inflammation index in critically ill patients with renal failure: a retrospective cohort study from Medical Information Mart for Intensive Care IV (MIMIC-IV) database

Objectives Systemic immune-inflammation index (SII) is a biomarker of inflammatory conditions; however, no scoring system has been evaluated for predicting mortality in patients with renal failure in intensive care unit (ICU). This study aimed to determine associations between SII level and mortalit...

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Main Authors: Yu-Cheng Chang, Chia-Ying Hsiao, Min-I Su, Ying-Hsiang Lee, Po-Lin Lin, Wei-Ru Chiou, Pi-Yi Chang
Format: Article
Language:English
Published: BMJ Publishing Group 2025-06-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/6/e094203.full
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author Yu-Cheng Chang
Chia-Ying Hsiao
Min-I Su
Ying-Hsiang Lee
Po-Lin Lin
Wei-Ru Chiou
Pi-Yi Chang
author_facet Yu-Cheng Chang
Chia-Ying Hsiao
Min-I Su
Ying-Hsiang Lee
Po-Lin Lin
Wei-Ru Chiou
Pi-Yi Chang
author_sort Yu-Cheng Chang
collection DOAJ
description Objectives Systemic immune-inflammation index (SII) is a biomarker of inflammatory conditions; however, no scoring system has been evaluated for predicting mortality in patients with renal failure in intensive care unit (ICU). This study aimed to determine associations between SII level and mortality in patients with renal failure.Design Using the Medical Information Mart for Intensive Care IV (V.2.0) database (USA), this retrospective study included 837 patients who were admitted to ICU with end-stage renal disease (ESRD), between 2008 and 2019.Primary and secondary outcome measures Cox proportional-hazards models were used to evaluate correlations between SII and outcomes, expressing results as hazard ratios (HRs) with 95% confidence intervals (95% CIs). Regression analysis was used to determine associations between variables and SII.Results In total, 837 adult patients from a total of 76 943 patients admitted to ICU were included, comprising 59.60% males with mean age 62.27±14.9 years and mean BMI 28.36±7.43 Kg/m2. Using median SII (1628 X 109 /L) as cut-off value, high (≥ 1628X109 /L) SII was also associated with an increased risk of ICU mortality (HR 1.97 (95% CI 1.15 to 3.35), p=0.034), in-hospital mortality (HR 1.95 (95% CI 1.23 to 3.09), p=0.017) and total mortality (HR 1.30 (95% CI 1.07 to 1.58), p=0.024).Conclusions SII may predict mortality in critically ill patients admitted to ICU with ESRD. SII ≥ 1628×109 /L correlates significantly with increased ICU mortality, in-hospital mortality and total mortality.
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spelling doaj-art-edb7a2f7ec294543be01eb5975b17b9d2025-08-20T02:31:13ZengBMJ Publishing GroupBMJ Open2044-60552025-06-0115610.1136/bmjopen-2024-094203Systemic immune-inflammation index in critically ill patients with renal failure: a retrospective cohort study from Medical Information Mart for Intensive Care IV (MIMIC-IV) databaseYu-Cheng Chang0Chia-Ying Hsiao1Min-I Su2Ying-Hsiang Lee3Po-Lin Lin4Wei-Ru Chiou5Pi-Yi Chang6Department of Cardiology, Asia University Hospital, Taichung, TaiwanDepartment of Medicine, MacKay Medical College, New Taipei, TaiwanDivision of Cardiology, Department of Internal Medicine, Taitung MacKay Memorial Hospital, Taitung, TaiwanDepartment of Artificial Intelligence and Medical Application, MacKay Junior College of Medicine, Nursing, and Management, Taipei, TaiwanDivision of Cardiology, Department of Internal Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu, TaiwanDivision of Cardiology, Department of Internal Medicine, Taitung MacKay Memorial Hospital, Taitung, TaiwanDepartment of Medical Imaging, Taichung Veterans General Hospital, Taichung, TaiwanObjectives Systemic immune-inflammation index (SII) is a biomarker of inflammatory conditions; however, no scoring system has been evaluated for predicting mortality in patients with renal failure in intensive care unit (ICU). This study aimed to determine associations between SII level and mortality in patients with renal failure.Design Using the Medical Information Mart for Intensive Care IV (V.2.0) database (USA), this retrospective study included 837 patients who were admitted to ICU with end-stage renal disease (ESRD), between 2008 and 2019.Primary and secondary outcome measures Cox proportional-hazards models were used to evaluate correlations between SII and outcomes, expressing results as hazard ratios (HRs) with 95% confidence intervals (95% CIs). Regression analysis was used to determine associations between variables and SII.Results In total, 837 adult patients from a total of 76 943 patients admitted to ICU were included, comprising 59.60% males with mean age 62.27±14.9 years and mean BMI 28.36±7.43 Kg/m2. Using median SII (1628 X 109 /L) as cut-off value, high (≥ 1628X109 /L) SII was also associated with an increased risk of ICU mortality (HR 1.97 (95% CI 1.15 to 3.35), p=0.034), in-hospital mortality (HR 1.95 (95% CI 1.23 to 3.09), p=0.017) and total mortality (HR 1.30 (95% CI 1.07 to 1.58), p=0.024).Conclusions SII may predict mortality in critically ill patients admitted to ICU with ESRD. SII ≥ 1628×109 /L correlates significantly with increased ICU mortality, in-hospital mortality and total mortality.https://bmjopen.bmj.com/content/15/6/e094203.full
spellingShingle Yu-Cheng Chang
Chia-Ying Hsiao
Min-I Su
Ying-Hsiang Lee
Po-Lin Lin
Wei-Ru Chiou
Pi-Yi Chang
Systemic immune-inflammation index in critically ill patients with renal failure: a retrospective cohort study from Medical Information Mart for Intensive Care IV (MIMIC-IV) database
BMJ Open
title Systemic immune-inflammation index in critically ill patients with renal failure: a retrospective cohort study from Medical Information Mart for Intensive Care IV (MIMIC-IV) database
title_full Systemic immune-inflammation index in critically ill patients with renal failure: a retrospective cohort study from Medical Information Mart for Intensive Care IV (MIMIC-IV) database
title_fullStr Systemic immune-inflammation index in critically ill patients with renal failure: a retrospective cohort study from Medical Information Mart for Intensive Care IV (MIMIC-IV) database
title_full_unstemmed Systemic immune-inflammation index in critically ill patients with renal failure: a retrospective cohort study from Medical Information Mart for Intensive Care IV (MIMIC-IV) database
title_short Systemic immune-inflammation index in critically ill patients with renal failure: a retrospective cohort study from Medical Information Mart for Intensive Care IV (MIMIC-IV) database
title_sort systemic immune inflammation index in critically ill patients with renal failure a retrospective cohort study from medical information mart for intensive care iv mimic iv database
url https://bmjopen.bmj.com/content/15/6/e094203.full
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