Work

Association between pan-immune inflammatory value and all-cause mortality in critically ill patients with ischemic stroke: a retrospective analysis of the MIMIC-IV database (2008–2022)

Year: 2025

Type: article

Abstract: Background: Systemic inflammation and immune responses are key contributors to the onset and progression of ischemic stroke, influencing both tissue damage and repair. This study investigates the association between the pan-immune inflammatory value (PIV)-a composite biomarker derived from routine blood tests-and all-cause mortality (ACM) in critically ill ischemic stroke patients. Methods: We extracted data from the MIMIC-IV (v3.0) database, identifying ischemic stroke patients using ICD-9/10 codes. PIV was calculated using the formula: (monocytes × neutrophils × platelets) ÷ lymphocytes. ACM was assessed during hospitalization and at 30-, 90-, and 365-days post-admission. Multivariable Cox proportional hazards models and restricted cubic spline (RCS) analyses were used to assess the relationship between PIV and mortality. Kaplan-Meier curves, time-dependent ROC curves, and decision curve analysis (DCA) evaluated survival differences and predictive performance. Subgroup and interaction analyses were conducted using likelihood ratio tests. Results: < 0.01). RCS analysis revealed a J-shaped relationship between PIV and ACM. Subgroup analyses showed consistent results without significant interaction effects. Conclusion: PIV is an independent predictor of short- and long-term mortality in critically ill ischemic stroke patients. These findings suggest PIV could serve as a practical and cost-effective biomarker for risk stratification and prognosis in clinical settings.

Source: Frontiers in Neurology

DOI: 10.3389/fneur.2025.1644817