Limited evidence exists on the association between the endothelial activation and stress index (EASIX) and mortality in anemia patients. This national cross-sectional study investigated the relationship between the EASIX and all-cause mortality in anemic individuals and assessed its clinical utility. We analyzed data from 2954 anemia patients in the NHANES (2003-2016), with mortality follow-up through December 31, 2019. Restricted cubic spline (RCS) analysis evaluated the EASIX-mortality association. The optimal EASIX cutoff value for survival was determined using the maximally selected rank statistics method (MSRSM). Weighted multivariate Cox regression and time-dependent receiver operating characteristic (ROC) curve analysis assessed EASIX's predictive performance. Over a median 81-month follow-up, 840 deaths (28.4%) occurred. RCS regression analysis revealed that higher EASIX scores were associated with increased all-cause mortality. Patients were categorized into lower (≤0.72) and higher (>0.72) EASIX groups based on the MSRM results. According to the multivariate-adjusted model, compared with the lower EASIX group, the higher EASIX group demonstrated an HR of 1.42 for all-cause mortality. Time-dependent ROC analysis revealed AUCs of 0.75, 0.75, 0.76, and 0.78 for 1-, 3-, 5-, and 10-year all-cause mortality, respectively. An elevated EASIX score, derived from routine clinical parameters, is independently associated with increased all-cause mortality in anemic patients. These findings suggest that the EASIX may serve as a valuable prognostic biomarker for risk stratification and could assist in guiding the management of anemia. Further prospective cohort studies are needed to confirm its prognostic value in this population.
Wu et al. (Wed,) studied this question.