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已发表论文
累积炎症指数与卒中相关性肺炎长期死亡率的关联
Authors Gao J, Wen Y, Xie M, Yuan K , Wang H , Sun S, Ma M, Xu G
Received 21 May 2025
Accepted for publication 27 October 2025
Published 2 December 2025 Volume 2025:18 Pages 16777—16787
DOI https://doi.org/10.2147/JIR.S541879
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Yuhan Xing
Jie Gao,1,* Yangchun Wen,2,* Mengdi Xie,1,* Kang Yuan,1 Huaiming Wang,3 Siyu Sun,4 Minmin Ma,1 Gelin Xu1
1Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, People’s Republic of China; 2Department of Neurology, Guangdong Heyuan Traditional Chinese Medicine Hospital, Heyuan, 517000, People’s Republic of China; 3Department of Neurology, The 80th Group Army Hospital of The People’s Liberation Army, Weifang, Shandong, 261021, People’s Republic of China; 4Department of Neurology, Jinling Hospital, Nanjing Medical University, Nanjing, 210002, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Minmin Ma, Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, Jiangsu, 210002, People’s Republic of China, Tel +86 2584801861, Fax +86 2584805169, Email mmm-xkx@163.com Gelin Xu, Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, Jiangsu, 210002, People’s Republic of China, Tel +86 2584801861, Fax +86 2584805169, Email gelinxu@nju.edu.cn
Background: Stroke-associated pneumonia (SAP) represents a common complication that increases the mortality risk in individuals who have experienced a stroke. We aimed to explore the relationship between the cumulative inflammatory index (IIC) and long-term mortality in patients with SAP.
Methods: This study sourced participants with SAP from the Nanjing Stroke Registry Program. The IIC was computed using the formula: (mean corpuscular volume × red cell distribution width × neutrophils) divided by (lymphocytes × 1000). To gauge the diagnostic utility of inflammatory markers, time-dependent receiver operating characteristic curves were plotted. Furthermore, to elucidate the connection between IIC and long-term mortality, survival analysis was conducted via Cox proportional hazard regression models.
Results: The analysis enrolled a total of 557 SAP patients, with a median age of 66 years and 391 males accounting for 70.2% of the cohort. The predictive accuracy of the IIC for mortality was 0.697 (95% confidence interval [CI]: 0.637– 0.757). In Cox proportional hazard regression models, the IIC was significantly related to mortality (continuous: hazard ratio [HR]: 1.04; 95% CI: 1.02– 1.06; P < 0.001; tertile 3 versus tertile 1: HR: 3.03; 95% CI: 1.75– 5.25; P < 0.001). Restricted cubic spline analysis demonstrated a progressively escalating association between IIC and mortality among SAP patients, with statistical significance (P = 0.003).
Conclusion: This research revealed that elevated IIC levels were linked to a heightened long-term mortality risk among individuals with SAP. IIC may emerge as a feasible and robust biomarker for mortality prediction in SAP patients.
Keywords: stroke, pneumonia, cumulative, mortality, red blood cell
1Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, People’s Republic of China; 2Department of Neurology, Guangdong Heyuan Traditional Chinese Medicine Hospital, Heyuan, 517000, People’s Republic of China; 3Department of Neurology, The 80th Group Army Hospital of The People’s Liberation Army, Weifang, Shandong, 261021, People’s Republic of China; 4Department of Neurology, Jinling Hospital, Nanjing Medical University, Nanjing, 210002, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Minmin Ma, Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, Jiangsu, 210002, People’s Republic of China, Tel +86 2584801861, Fax +86 2584805169, Email mmm-xkx@163.com Gelin Xu, Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, Jiangsu, 210002, People’s Republic of China, Tel +86 2584801861, Fax +86 2584805169, Email gelinxu@nju.edu.cn
Background: Stroke-associated pneumonia (SAP) represents a common complication that increases the mortality risk in individuals who have experienced a stroke. We aimed to explore the relationship between the cumulative inflammatory index (IIC) and long-term mortality in patients with SAP.
Methods: This study sourced participants with SAP from the Nanjing Stroke Registry Program. The IIC was computed using the formula: (mean corpuscular volume × red cell distribution width × neutrophils) divided by (lymphocytes × 1000). To gauge the diagnostic utility of inflammatory markers, time-dependent receiver operating characteristic curves were plotted. Furthermore, to elucidate the connection between IIC and long-term mortality, survival analysis was conducted via Cox proportional hazard regression models.
Results: The analysis enrolled a total of 557 SAP patients, with a median age of 66 years and 391 males accounting for 70.2% of the cohort. The predictive accuracy of the IIC for mortality was 0.697 (95% confidence interval [CI]: 0.637– 0.757). In Cox proportional hazard regression models, the IIC was significantly related to mortality (continuous: hazard ratio [HR]: 1.04; 95% CI: 1.02– 1.06; P < 0.001; tertile 3 versus tertile 1: HR: 3.03; 95% CI: 1.75– 5.25; P < 0.001). Restricted cubic spline analysis demonstrated a progressively escalating association between IIC and mortality among SAP patients, with statistical significance (P = 0.003).
Conclusion: This research revealed that elevated IIC levels were linked to a heightened long-term mortality risk among individuals with SAP. IIC may emerge as a feasible and robust biomarker for mortality prediction in SAP patients.
Keywords: stroke, pneumonia, cumulative, mortality, red blood cell