Systemic immune-inflammation index and in-hospital mortality in critically ill patients with acute asthma exacerbation: A retrospective cohort study.
- 1Faculty of Medicine, College of Health Sciences, Nam Can Tho University, Can Tho, Vietnam.
- 2Critical Care Department, Nam Can Tho University Medical Center, Can Tho, Vietnam.
Abstract
The prognostic value of the systemic immune-inflammation index (SII) in critically ill patients with acute asthma exacerbations remains unclear. This study examined the association between SII and in-hospital mortality. We performed a retrospective cohort study using the MIMIC-IV (v3.1) database, including adult critically ill patients with asthma exacerbations. SII was calculated from laboratory values obtained during the peri-intensive care unit admission period. The primary outcome was in-hospital mortality. Associations were assessed using restricted cubic spline and Cox proportional hazards models, adjusted for confounders. A total of 575 patients were included, with an overall in-hospital mortality of 6.6%. Mortality rates differed significantly across SII tertiles and were highest in tertile 3 (11.5%), compared with tertile 2 (3.6%) and tertile 1 (4.7%) (P = .003). In Cox proportional hazards models, compared with tertile 2, patients in tertile 3 had a significantly increased risk of in-hospital mortality (unadjusted hazard ratio [HR] 2.88, 95% confidence interval [CI] 1.21-6.83, P = .016; adjusted HR 2.82, 95% CI 1.12-7.10, P = .027), whereas no significant difference was observed for tertile 1. Restricted cubic spline analysis based on natural logarithm-transformed (ln-SII) demonstrated a significant nonlinear association with in-hospital mortality (P for nonlinearity < .001), with risk increasing markedly at higher ln-SII levels. Elevated SII was associated with increased in-hospital mortality and may serve as a simple prognostic marker in critically ill asthma exacerbations.
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BibTeX
@article{huynh2026systemic,
title = {{Systemic immune-inflammation index and in-hospital mortality in critically ill patients with acute asthma exacerbation: A retrospective cohort study.}},
author = {Phan Ngoc An Huynh and Vu Thanh Le and Ngoc Thu Le and Ngoc Nhu Y Nguyen and Van Hoang Nam Ho and Thi Thu Phuong Lam and Khoi Minh Tran and Cong Dang Tran and Thanh Luan Nguyen},
journal = {Medicine},
year = {2026},
month = oct,
doi = {10.1097/md.0000000000051080},
url = {https://europepmc.org/article/MED/42888589},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Systemic immune-inflammation index and in-hospital mortality in critically ill patients with acute asthma exacerbation: A retrospective cohort study.
AU - Phan Ngoc An Huynh
AU - Vu Thanh Le
AU - Ngoc Thu Le
AU - Ngoc Nhu Y Nguyen
AU - Van Hoang Nam Ho
AU - Thi Thu Phuong Lam
AU - Khoi Minh Tran
AU - Cong Dang Tran
AU - Thanh Luan Nguyen
PY - 2026
DA - 2026/10/01
JO - Medicine
DO - 10.1097/md.0000000000051080
UR - https://europepmc.org/article/MED/42888589
AB - The prognostic value of the systemic immune-inflammation index (SII) in critically ill patients with acute asthma exacerbations remains unclear. This study examined the association between SII and in-hospital mortality. We performed a retrospective cohort study using the MIMIC-IV (v3.1) database, including adult critically ill patients with asthma exacerbations. SII was calculated from laboratory values obtained during the peri-intensive care unit admission period. The primary outcome was in-hospital mortality. Associations were assessed using restricted cubic spline and Cox proportional hazards models, adjusted for confounders. A total of 575 patients were included, with an overall in-hospital mortality of 6.6%. Mortality rates differed significantly across SII tertiles and were highest in tertile 3 (11.5%), compared with tertile 2 (3.6%) and tertile 1 (4.7%) (P = .003). In Cox proportional hazards models, compared with tertile 2, patients in tertile 3 had a significantly increased risk of in-hospital mortality (unadjusted hazard ratio [HR] 2.88, 95% confidence interval [CI] 1.21-6.83, P = .016; adjusted HR 2.82, 95% CI 1.12-7.10, P = .027), whereas no significant difference was observed for tertile 1. Restricted cubic spline analysis based on natural logarithm-transformed (ln-SII) demonstrated a significant nonlinear association with in-hospital mortality (P for nonlinearity < .001), with risk increasing markedly at higher ln-SII levels. Elevated SII was associated with increased in-hospital mortality and may serve as a simple prognostic marker in critically ill asthma exacerbations.
SN - 0304-5412
SN - 1536-5964
ER -