Neurosurgical review · 2025
Association between endothelial activation and stress index and all-cause mortality in intensive care unit patients with intracerebral hemorrhage: A retrospective cohort study.
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Cai Shengyu, Lin Shihong, Yang Baoya, Chen Jianlong, Wu Zhe, Liu Yiqi, Lai Jinqing, Xu Chaoyang, Lin Weibin, Zeng Yile
Аннотация
Endothelial Activation and Stress Index (EASIX) is a marker of endothelial dysfunction that could serve as a predictive tool for mortality in multiple disease. This study aimed to investigate the relationship between EASIX and all-cause mortality in patients with intracerebral hemorrhage (ICH) admitted to the intensive care unit (ICU).A retrospective cohort study was conducted using data from the MIMIC-IV database. The study included 838 ICH patients. Cox regression analysis was performed to assess the association between EASIX quartiles and mortality at 7, 30, 90, and 180 days. Kaplan-Meier survival curves and restricted cubic spline models were used to evaluate mortality risk across EASIX quartiles, and subgroup analyses were conducted to assess the consistency of findings across different patient groups.EASIX was significantly associated with increased mortality at all time points. Higher EASIX quartiles (Q4) were strongly correlated with higher mortality risk at 7 days (HR for Q4: 9.31), 30 days (HR for Q4: 3.85), 90 days (HR for Q4: 3.23), and 180 days (HR for Q4: 3.31) (p < 0.001 for all). Multivariate analysis confirmed that EASIX remained a significant predictor of mortality after adjusting for confounding factors such as age, sex, heart rate, mean blood pressure, SpO2, diabetes, myocardial infarct, congestive heart failure, renal disease, severe liver disease and chronic pulmonary disease. Subgroup analyses further indicated the robustness of these results.EASIX is a robust and reliable predictor of both short- and long-term mortality in ICH patients admitted to the ICU.