Department of Critical Care Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen 518033, China.
Department of Critical Care Medicine, The 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen 518033, China.
Int J Med Sci. 2023 Jul 31;20(9):1165-1173. doi: 10.7150/ijms.85870. eCollection 2023.
Endothelial Activation and Stress Index (EASIX) is a reliable alternative biomarker of endothelial dysfunction. Because endothelial activation is involved in sepsis pathophysiology, we aimed to investigate the association between EASIX and prognosis in septic patients. Data were extracted from the Medical Information Mart for Intensive Care (MIMIC) IV database. EASIX scores were calculated using the formula: lactate dehydrogenase (U/L) × creatinine (mg/dL)/platelet count (10/L). Patients were grouped into tertiles according to log2 transformed EASIX. The primary and secondary outcomes were 28-day and 90-day mortality. Cox proportional hazards models, Kaplan-Meier curves, restricted cubic spline curves, and subgroup analyses were conducted to evaluate the association between EASIX and prognosis in septic patients. A total of 7504 patients were included. Multivariable Cox proportional hazards analyses showed that higher log2-EASIX was associated with increased risk of 28-day mortality (HR, 1.10; 95% CI, 1.07-1.13; < 0.001). Compared with tertile 1, the tertile 2 and 3 groups had higher risk of 28-day mortality [HR (95% CI) 1.24 (1.09-1.41); HR (95% CI) 1.51 (1.31-1.74)]; for trend < 0.001). Similar results were found for 90-day mortality. Kaplan-Meier curves showed that patients with higher EASIX had lower 28-day and 90-day survival rates. A linear relationship was found between log2-EASIX and 28-day and 90-day mortality. High EASIX was significantly associated with an increased risk of 28-day and 90-day all-cause mortality in patients with sepsis.
内皮细胞激活和应激指数 (EASIX) 是内皮功能障碍的可靠替代生物标志物。由于内皮细胞激活参与脓毒症病理生理学，我们旨在研究 EASIX 与脓毒症患者预后的关系。数据来自医疗信息监护网 (MIMIC) IV 数据库。EASIX 评分通过以下公式计算：乳酸脱氢酶 (U/L) × 肌酐 (mg/dL)/血小板计数 (10/L)。根据 log2 转换后的 EASIX 将患者分为三分位组。主要和次要结局分别为 28 天和 90 天死亡率。Cox 比例风险模型、Kaplan-Meier 曲线、限制立方样条曲线和亚组分析用于评估 EASIX 与脓毒症患者预后的关系。共纳入 7504 例患者。多变量 Cox 比例风险分析表明，较高的 log2-EASIX 与 28 天死亡率增加相关 (HR, 1.10; 95%CI, 1.07-1.13; <0.001)。与三分位 1 相比，三分位 2 和 3 组 28 天死亡率更高 [HR(95%CI)1.24(1.09-1.41); HR(95%CI)1.51(1.31-1.74)]; 趋势检验<0.001)。90 天死亡率也有类似结果。Kaplan-Meier 曲线显示，EASIX 较高的患者 28 天和 90 天生存率较低。log2-EASIX 与 28 天和 90 天死亡率之间存在线性关系。EASIX 升高与脓毒症患者 28 天和 90 天全因死亡率增加显著相关。
