Elevated inflammatory burden index increases mortality in adults with chronic inflammatory airway diseases: a nationwide cohort study

Ning Zhu; Shanhong Lin; Linfeng Wang; Xue Kong; Weina Huang; Chao Cao

doi:10.1186/s12890-024-03211-6

BMC Pulmonary Medicine (Aug 2024)

Elevated inflammatory burden index increases mortality in adults with chronic inflammatory airway diseases: a nationwide cohort study

Ning Zhu,
Shanhong Lin,
Linfeng Wang,
Xue Kong,
Weina Huang,
Chao Cao

Affiliations

Ning Zhu: Department of Respiratory and Critical Care Medicine, Key Laboratory of Respiratory Disease of Ningbo, The First Affiliated Hospital of Ningbo University
Shanhong Lin: Department of Ultrasound, The First Affiliated Hospital of Ningbo University
Linfeng Wang: Department of Respiratory and Critical Care Medicine, Key Laboratory of Respiratory Disease of Ningbo, The First Affiliated Hospital of Ningbo University
Xue Kong: Department of Respiratory and Critical Care Medicine, Key Laboratory of Respiratory Disease of Ningbo, The First Affiliated Hospital of Ningbo University
Weina Huang: Department of Respiratory and Critical Care Medicine, Key Laboratory of Respiratory Disease of Ningbo, The First Affiliated Hospital of Ningbo University
Chao Cao: Department of Respiratory and Critical Care Medicine, Key Laboratory of Respiratory Disease of Ningbo, The First Affiliated Hospital of Ningbo University

DOI: https://doi.org/10.1186/s12890-024-03211-6
Journal volume & issue: Vol. 24, no. 1
pp. 1 – 13

Abstract

Read online

Abstract Objective The objective of this study was to investigate the potential association between the inflammatory burden index (IBI) and the prevalence of chronic inflammatory airway diseases (CIAD), as well as mortality rates among individuals diagnosed with CIAD. Methods Participants were sourced from the National Health and Nutrition Examination Survey (NHANES) conducted between 1999 and 2010. The IBI was calculated using the formula: IBI = C-reactive protein * neutrophils / lymphocytes. CIAD comprised self-reported asthma, chronic bronchitis, and chronic obstructive pulmonary disease (COPD). Mortality outcomes, including all-cause and respiratory disease mortality, were determined through linked data from the National Death Index (NDI) up to December 2019. Results A total of 27,495 adults were included. IBI was divided into quartiles, with the lowest quartile as the reference group. After adjusting for confounding variables, a positive correlation was observed between higher IBI and increased prevalence of total CIAD (OR = 1.383 [1.215–1.575]), asthma (OR = 1.267 [1.096–1.465]), chronic bronchitis (OR = 1.568 [1.263–1.946]), and COPD (OR = 1.907 [1.311–2.774]). Over a median follow-up of 12.33 [9.92-16.00] years, there were 1221 deaths from all causes and 220 deaths from respiratory disease among 4499 patients with CIAD. Following multivariate adjustments, the fourth quartile was significantly associated with increased risk of all-cause mortality (HR = 2.227 [1.714–2.893]) and respiratory disease mortality (HR = 2.748 [1.383–5.459]) compared to the first quartile of IBI in CIAD participants. Moreover, variable importance analysis using a random survival forest model demonstrated the significance of IBI in predicting mortality from both all-cause and respiratory diseases. Conclusion IBI exhibited an association with the prevalence of CIAD, with higher IBI levels correlating with elevated all-cause and respiratory disease mortality among individuals with CIAD.

Published in BMC Pulmonary Medicine

ISSN: 1471-2466 (Online)
Publisher: BMC
Country of publisher: United Kingdom
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the respiratory system
Website: http://bmcpulmmed.biomedcentral.com

About the journal

Abstract

Keywords