Lu Yan, Guo Haoyang, Zhang Qiaohong
Clinical Laboratory, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, People's Republic of China.
Int J Gen Med. 2025 Aug 26;18:4825-4835. doi: 10.2147/IJGM.S542944. eCollection 2025.
Inflammation is a major contributor to prolonged hospital stays, increased healthcare costs, and poor prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). This study aimed to investigate the relationship between the Pan-Immune Inflammation Value (PIV), a novel immune-inflammatory biomarker, and the prolonged hospital stays in patients hospitalized for the first time with AECOPD to provide an effective risk assessment tool for clinical practice.
We retrospectively analyzed clinical data from 5810 patients admitted to the Affiliated Dongyang Hospital of Wenzhou Medical University between January 2010 and March 2024, with AECOPD as the primary diagnosis. Prolonged hospital stay was defined as a stay exceeding the 75th percentile for all included patients (length of hospital stay > 10 days). The association between PIV and prolonged hospital stay in patients with AECOPD was assessed using multi-model logistic regression analysis, restricted cubic spline (RCS) curves, and subgroup analysis.
Higher log-PIV values were significantly associated with prolonged hospital stay in patients with AECOPD. Multivariate regression analysis revealed that log-PIV (≥ 10.08) was an independent predictor of prolonged hospital stay (odds ratio = 1.57; 95% confidence Interval: 1.21-2.02; = 0.001). Furthermore, RCS regression demonstrated a linear correlation between log-PIV and the risk of prolonged hospital stay. Subgroup analysis confirmed the consistency of this association across different patient populations.
PIV is a potential biomarker for predicting prolonged hospital stay in patients hospitalized for the first time with AECOPD, providing a new assessment tool for clinical practice. The results of this study can help guide clinical decision-making, optimize treatment strategies, improve patient prognosis, and provide a scientific basis for the rational allocation of healthcare resources.
炎症是慢性阻塞性肺疾病急性加重（AECOPD）患者住院时间延长、医疗费用增加及预后不良的主要因素。本研究旨在探讨新型免疫炎症生物标志物全免疫炎症值（PIV）与首次因AECOPD住院患者住院时间延长之间的关系，为临床实践提供有效的风险评估工具。
我们回顾性分析了2010年1月至2024年3月期间温州医科大学附属东阳医院收治的5810例以AECOPD为主要诊断的患者的临床资料。住院时间延长定义为超过所有纳入患者第75百分位数的住院时间（住院时间>10天）。采用多模型逻辑回归分析、限制性立方样条（RCS）曲线和亚组分析评估AECOPD患者中PIV与住院时间延长之间的关联。
较高的log-PIV值与AECOPD患者住院时间延长显著相关。多变量回归分析显示，log-PIV（≥10.08）是住院时间延长的独立预测因素（比值比=1.57；95%置信区间：1.21-2.02；P=0.001）。此外，RCS回归显示log-PIV与住院时间延长风险之间存在线性相关性。亚组分析证实了不同患者群体中这种关联的一致性。
PIV是预测首次因AECOPD住院患者住院时间延长的潜在生物标志物，为临床实践提供了新的评估工具。本研究结果有助于指导临床决策、优化治疗策略、改善患者预后，并为合理分配医疗资源提供科学依据。
