PloS one · 2026
Association of leuko-glycemic index with mortality in ICU patients with Acute kidney injury: A retrospective multicenter cohort study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Ye Xuejin, Chen Sheng, Guo Lin, Ma Xiaohan, Wu Lingling, Li Yiwen, Zhang Ting, Jiang Peng, Gao Hongjun
Аннотация
BACKGROUND: Acute kidney injury (AKI) complicates the course of critical illness and carries high short- and long-term mortality rates; however, reliable early prognostic markers remain limited. The leuko-glycemic index (LGI), the product of white blood cell counts and blood glucose, has shown prognostic value in other acute conditions; however, its role in intensive care unit (ICU) patients with AKI remains unexplored.
METHODS: In this multicenter retrospective cohort study, we analyzed 112,235 adult ICU admissions from the MIMIC-IV (n = 54,840) and eICU-CRD (n = 57,395) databases. Patients with multiple ICU stays and those aged <18 years were excluded. The LGI was calculated within 24 h of admission and stratified into quartiles (Q1-Q4). The primary endpoints were 30- and 90-day in-hospital mortality, and the secondary endpoint was overall in-hospital mortality. Kaplan-Meier survival curves, multivariable Cox proportional hazards models, and restricted cubic splines (RCS) assess the association between LGI and outcomes, with subgroup and interaction analyses for key comorbidities.
RESULTS: Higher LGI quartiles were associated with progressively worse survival (p < 0.0001). In the fully adjusted models, each unit increase in LGI conferred a small but significant rise in 30-day (HR 1.01; 95% CI 1.01-1.01) and 90-day mortality (HR 1.01; 95% CI 1.01-1.01), while Q4 versus Q1 yielded HRs of 1.22 (95% CI 1.13-1.31) and 1.21 (95% CI 1.13-1.30), respectively. RCS demonstrated a nonlinear relationship, and the associations persisted across subgroups.
CONCLUSION: LGI may be an independent biomarker associated with short-term mortality in ICU patients with AKI. Its potential clinical relevance warrants further investigation and validation in larger cohorts.
METHODS: In this multicenter retrospective cohort study, we analyzed 112,235 adult ICU admissions from the MIMIC-IV (n = 54,840) and eICU-CRD (n = 57,395) databases. Patients with multiple ICU stays and those aged <18 years were excluded. The LGI was calculated within 24 h of admission and stratified into quartiles (Q1-Q4). The primary endpoints were 30- and 90-day in-hospital mortality, and the secondary endpoint was overall in-hospital mortality. Kaplan-Meier survival curves, multivariable Cox proportional hazards models, and restricted cubic splines (RCS) assess the association between LGI and outcomes, with subgroup and interaction analyses for key comorbidities.
RESULTS: Higher LGI quartiles were associated with progressively worse survival (p < 0.0001). In the fully adjusted models, each unit increase in LGI conferred a small but significant rise in 30-day (HR 1.01; 95% CI 1.01-1.01) and 90-day mortality (HR 1.01; 95% CI 1.01-1.01), while Q4 versus Q1 yielded HRs of 1.22 (95% CI 1.13-1.31) and 1.21 (95% CI 1.13-1.30), respectively. RCS demonstrated a nonlinear relationship, and the associations persisted across subgroups.
CONCLUSION: LGI may be an independent biomarker associated with short-term mortality in ICU patients with AKI. Its potential clinical relevance warrants further investigation and validation in larger cohorts.