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June 28, 2026MedicineOpen Access

Nonlinear association between systemic inflammation response index and mortality in adult cardiac surgery–associated acute kidney injury: A retrospective Cohort study based on the MIMIC-IV database

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Authors

TTTong TanCapital Medical UniversityAAAlimujiang AwakerBeijing Anzhen HospitalYLYongqiang LaiBeijing Anzhen Hospital

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Overview

Retrospective cohort study finds a U-shaped relationship between SIRI and mortality in CSA-AKI, indicating implications for risk assessment.

Key Points

  • This study investigates the relationship between the systemic inflammation response index (SIRI) and in-hospital mortality in patients with cardiac surgery-associated acute kidney injury (CSA-AKI).
  • Extracted data from 5394 CSA-AKI patients in the MIMIC-IV 3.1 database.
  • Calculated SIRI and categorized it into three tertiles.
  • Used restricted cubic spline models and multivariate logistic regression to analyze the association between SIRI and mortality.
  • Patients in the medium SIRI tertile had the lowest mortality rate (1.3%) compared to low (2.0%) and high (3.1%) tertiles.
  • RCS analysis indicated a significant U-shaped association: lower mortality risk below SIRI = 1.6899 and a 10% increased mortality risk per 1-unit increase above this threshold (OR 1.10, 95% CI 1.03–1.16, P = .001).
  • SIRI may serve as a practical biomarker for assessing immune homeostasis and postoperative risk in CSA-AKI.

Cite This Study

Tan et al. (2026) studied this question.

synapsesocial.com/papers/6a40bae361bb0a67205c693bhttps://doi.org/10.1097/md.0000000000049168
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