ArticleScientific reports2025
Pan immune inflammation value improves MELD 3.0 for mortality prediction in critically ill cirrhotic patients.
Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Liver cirrhosis poses a significant global health burden, with over 100 million cases worldwide and 2 million annual deaths. Despite advances in prognostic tools like MELD 3.0, their performance remains suboptimal. The pan-immune-inflammation value (PIV), a novel biomarker of systemic inflammation, has shown prognostic utility in chronic diseases but remains underexplored in cirrhosis. This study evaluates PIV's predictive value for mortality in critically ill cirrhotic patients and its synergy with MELD 3.0. Using data from the MIMIC-IV database, we analyzed 2,399 critically ill cirrhotic patients. PIV was calculated as neutrophils × platelets × monocytes/lymphocytes. Primary and secondary endpoints were 28-day and 365-day all-cause mortality, respectively. Multivariable Cox models, restricted cubic splines, and time-dependent ROC analyses, calibration curves, and clinical decision curve analyses were employed to assess associations and predictive performance. Patients in the highest PIV quartile (Q4) exhibited older age, more comorbidities, and worse metabolic profiles compared to Q1. PIV demonstrated a J-shaped association with mortality: Q4 had 0.51-fold higher 28-day mortality than Q1 (adjusted HR = 1.51, P < 0.001). The PIV-MELD 3.0 composite model outperformed individual markers, with AUCs of 69.5 (95% CI:0.68-0.71) (28-day) and 69.4 (95% CI:0.69-0.70) (365-day). Non-linear analysis revealed a J-shaped threshold effect with cut-off values of 3.33 (28-day) and 3.13 (365-day). Calibration curves and sensitivity analysis confirmed the superiority of the PIV combined with the MELD 3.0 model. Finally, sensitivity, subgroup, and external validation analyses further demonstrated the robustness of the association between PIV and mortality risk. PIV independently predicts short- and long-term mortality in cirrhotic patients, exhibiting a dose-response relationship. Integration with MELD 3.0 enhances risk stratification, offering a cost-effective tool for clinical decision-making. Prospective studies are warranted to validate these findings.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.