BMC pediatrics · 2026
Association of Aggregate Index of Systemic Inflammation (AISI) with all-cause mortality in critically Ill pediatric patients: a retrospective cohort study.
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Tian De-Chun, Zhang Xiao-Lan, Chen Chun-Jiang, Liu Cheng-Long
Аннотация
BACKGROUND: Growing evidence supports the prognostic utility of AISI in adults, but its association with mortality in the critically ill pediatric population remains poorly characterized.
OBJECTIVE: To investigate the association between AISI and 28-day all-cause mortality in critically ill pediatric patients.
METHODS: A total of 8,797 patients admitted to the pediatric intensive care unit were included from the PIC Database. The AISI was log₂-transformed and categorized into four groups based on quartiles. The outcomes included 28-day all-cause mortality, both in-hospital and in-ICU. Cox proportional hazards regression, restricted cubic spline, two-piecewise threshold model, and subgroup analyses were used to evaluate the association between AISI and 28-day all-cause mortality.
RESULTS: Males accounted for 4,930 (56.0%) of the patients. The overall 28-day in-hospital and ICU all-cause mortality rates were 4.3% and 4.2%, respectively. The RCS analysis revealed a significant nonlinear association between the log2-transformed AISI and both mortality outcomes. Threshold effect analysis identified that the threshold points of log₂-AISI were 5.410 and 5.407 for 28-day in-hospital and ICU mortality, respectively. Subgroup analyses revealed no notable differences between specific patient subgroups.
CONCLUSIONS: This study suggests a nonlinear association between AISI and 28-day mortality in critically ill pediatric patients. AISI levels above the threshold were independently associated with an increased mortality risk.
OBJECTIVE: To investigate the association between AISI and 28-day all-cause mortality in critically ill pediatric patients.
METHODS: A total of 8,797 patients admitted to the pediatric intensive care unit were included from the PIC Database. The AISI was log₂-transformed and categorized into four groups based on quartiles. The outcomes included 28-day all-cause mortality, both in-hospital and in-ICU. Cox proportional hazards regression, restricted cubic spline, two-piecewise threshold model, and subgroup analyses were used to evaluate the association between AISI and 28-day all-cause mortality.
RESULTS: Males accounted for 4,930 (56.0%) of the patients. The overall 28-day in-hospital and ICU all-cause mortality rates were 4.3% and 4.2%, respectively. The RCS analysis revealed a significant nonlinear association between the log2-transformed AISI and both mortality outcomes. Threshold effect analysis identified that the threshold points of log₂-AISI were 5.410 and 5.407 for 28-day in-hospital and ICU mortality, respectively. Subgroup analyses revealed no notable differences between specific patient subgroups.
CONCLUSIONS: This study suggests a nonlinear association between AISI and 28-day mortality in critically ill pediatric patients. AISI levels above the threshold were independently associated with an increased mortality risk.