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Research on the Use of AISI for Predicting the Risk of Mortality in Patients with ARDS
Received date: 2026-03-05
Revised date: 2026-03-26
Accepted date: 2026-04-20
Online published: 2026-06-29
Objective： To investigate the relationship between the aggregate index of systemic inflammation （AISI） and short-term and long-term mortality in ICU patients with acute respiratory distress syndrome （ARDS）.Methods： A retrospective cohort study was conducted on 1534 ARDS patients based on data from the MIMIC-IV 3.0 database.The analysis included multivariable Cox proportional hazards regression to assess the impact of AISI scores on all-cause mortality， with restricted cubic splines （RCS） used for exploring potential non-linear relationships. Optimal AISI cutoff values were determined using X-title software， dividing the cohort into two groups. Kaplan-Meier survival curves were compared across these groups， supplemented by subgroup analyses to validate findings.Results： Among 1534 ARDS patients， the 30-day mortality rate and 1-year mortality rate of patients in the high AISI group after ICU admission were both higher than those in the low AISI group. RCS curve fitting indicated a significant non-linear correlation between AISI and both 30 d （P=0.021） and 1 year mortality （P<0.001）. Cox regression after full adjustment showed that AISI≥1528 was significantly associated with higher risks of mortality at 30 d （HR=1.248， 95% CI： 1.017-1.532） and 1 year （HR=1.333， 95% CI： 1.120-1.587） compared to AISI<1528. Subgroup analyses highlighted significant relevance between AISI and mortality in ARDS patients with diabetes and those treated with furosemide （P<0.05）.Conclusion： AISI is a significant predictor of both 30 d mortality and 1 year mortality in ARDS patients in ICU. It may serve as an effective tool for identifying high-risk patients early and guiding personalized treatment strategies.
ZHANG Haibo, PENG Weibin, LI Jiebin, WANG Dawei, CHEN Yu, ZHANG Jing
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Research on the Use of AISI for Predicting the
Risk of Mortality in Patients with ARDS
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