Associations between Global Immune-Nutrition-Inflammation Index and Risk of Mortality in Intensive Care Unit Patients.

Purpose

This retrospective study aimed to evaluate the association between the newly developed Global Immune-Nutrition-Inflammation (GINI) index and the risk of all-cause mortality among patients admitted to the intensive care unit (ICU).

Methods

Data were extracted from the Medical Information Mart for Intensive Care IV version 3.0 (MIMIC-IV-3.0) database. Associations between the GINI index and all-cause mortality were assessed using Kaplan-Meier survival curves and multivariate weighted Cox regression models. Additionally, restricted cubic spline (RCS) analyses were performed to explore potential non-linear relationships between the GINI index and hazard ratios (HRs). Subgroup analyses were conducted to evaluate possible interactions between the GINI index and selected clinical features.

Results

A total of 970 patients were included, of whom 11.75% (N = 114) experienced all-cause mortality. A significant association was observed between a higher GINI index and increased risk of all-cause mortality. This association remained consistent when the GINI index was treated as a continuous variable (HR = 1.12; P = 0.03) and when categorized into groups (Group 2 vs. Group 1: HR = 1.97; P = 0.02; Group 3 vs. Group 1: HR = 2.17; P = 0.01). The RCS analysis supported a linear, rather than a non-linear, relationship between the GINI index and all-cause mortality (P > 0.05 for non-linearity).

Conclusions

The GINI index is associated with elevated all-cause mortality risk among ICU patients and may serve as a promising candidate for mortality risk stratification, which highlights the potential benefit of timely targeted intervention.