Association between systemic inflammatory response index (SIRI) and all-cause mortality in patients with heart failure: a retrospective analysis based on the largescale clinical database MIMIC-IV

Association between systemic inflammatory response index (SIRI) and all-cause mortality in patients with heart failure: a retrospective analysis based on the largescale clinical database MIMIC-IV | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Association between systemic inflammatory response index (SIRI) and all-cause mortality in patients with heart failure: a retrospective analysis based on the largescale clinical database MIMIC-IV Chen Wang, Ligai Zhang, Shiqing Xiang, Xuan Chu, Hong Wu, Pinliang Liao This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7035962/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background The Systemic Inflammatory Response Index (SIRI), a new prognostic biomarker, has been identified and shown to be associated with poor prognosis in many cardiovascular diseases. However, its relationship with heart failure is unclear, and the aim of this study was to investigate the relationship between SIRI and all-cause mortality in patients with heart failure. Method This study identified patients with heart failure admitted to the ICU from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database and categorized them into four groups based on SIRI quartiles. The primary study endpoint was 30-day all-cause mortality, and secondary study endpoints were 90-day, 180-day and 360-day all-cause mortality. A Cox regression proportional risk model was used to assess the risk of SIRI on outcome events, and restricted cubic spline (RCS) was employed to estimate the nonlinear association between SIRI and outcome events. Kaplan-Meier analysis was utilized to evaluate the relationship between SIRI and all-cause mortality in patients with heart failure. Subgroup analyses were performed to confirm the effect of SIRI on heart failure mortality in different subgroups. Result The study enrolled 6395 patients with a diagnosis of heart failure. After 30, 90, 180, and 360 days of follow-up, the mortality rates were 18.42%, 25.87%, 30.26%, and 35.76%, respectively. A Cox regression proportional risk model showed that after adjusting for the full range of possible confounders, it was found that the mortality rate was also higher in the group with high SIRI levels as compared to the group with low levels of SIRI (30-day: HR=2.39, and 95% CI = 1.91-2.98, P < 0.001 ; 90 days: HR = 2.25, 95% CI = 1.87-2.71, P < 0.001; 180 days: HR = 1.93, 95% CI = 1.63-2.29, P < 0.001; 360 days: HR = 1.88, 95% CI-= 1.61-2.20, P < 0.001). According to the Kaplan-Meier results, patients with higher SIRI had a significantly higher risk of all-cause mortality (P < 0.001). In addition, restricted cubic spline analysis showed a J-shaped (J-shaped) nonlinear relationship between SIRI and all-cause mortality in patients with heart failure. Subgroup analyses showed that SIRI did not interact with most subgroups, but the effect of SIRI on mortality was greater in the non-sepsis group. Conclusion SIRI was significantly associated with short-and long-term all-cause mortality in patients with heart failure and may become a predictor of prognosis in heart failure patients in the future. Health sciences/Biomarkers Health sciences/Cardiology Health sciences/Diseases Health sciences/Medical research Health sciences/Risk factors Systemic inflammation response index Heart failure Inflammation MIMIC-IV All-cause mortality Full Text Additional Declarations No competing interests reported. Supplementary Files CITI.pdf date.csv Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7035962","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":486902162,"identity":"40fd1c2c-2dbd-48eb-ba11-9758fa2077e9","order_by":0,"name":"Chen Wang","email":"","orcid":"","institution":"the First Affiliated Hospital of the Army Medical University","correspondingAuthor":false,"prefix":"","firstName":"Chen","middleName":"","lastName":"Wang","suffix":""},{"id":486902163,"identity":"a0d3d1f5-e3f2-4293-92f2-5f953a7ea362","order_by":1,"name":"Ligai Zhang","email":"","orcid":"","institution":"the First Affiliated Hospital of the Army Medical 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MIMIC-IV","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Systemic inflammation response index, Heart failure, Inflammation, MIMIC-IV, All-cause mortality","lastPublishedDoi":"10.21203/rs.3.rs-7035962/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7035962/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Systemic Inflammatory Response Index (SIRI), a new prognostic biomarker, has been identified and shown to be associated with poor prognosis in many cardiovascular diseases. However, its relationship with heart failure is unclear, and the aim of this study was to investigate the relationship between SIRI and all-cause mortality in patients with heart failure.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis study identified patients with heart failure admitted to the ICU from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database and categorized them into four groups based on SIRI quartiles. The primary study endpoint was 30-day all-cause mortality, and secondary study endpoints were 90-day, 180-day and 360-day all-cause mortality. A Cox regression proportional risk model was used to assess the risk of SIRI on outcome events, and restricted cubic spline (RCS) was employed to estimate the nonlinear association between SIRI and outcome events. Kaplan-Meier analysis was utilized to evaluate the relationship between SIRI and all-cause mortality in patients with heart failure. Subgroup analyses were performed to confirm the effect of SIRI on heart failure mortality in different subgroups.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResult\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe study enrolled 6395 patients with a diagnosis of heart failure. After 30, 90, 180, and 360 days of follow-up, the mortality rates were 18.42%, 25.87%, 30.26%, and 35.76%, respectively. A Cox regression proportional risk model showed that after adjusting for the full range of possible confounders, it was found that the mortality rate was also higher in the group with high SIRI levels as compared to the group with low levels of SIRI (30-day: HR=2.39, and 95% CI = 1.91-2.98, P \u0026lt; 0.001 ; 90 days: HR = 2.25, 95% CI = 1.87-2.71, P \u0026lt; 0.001; 180 days: HR = 1.93, 95% CI = 1.63-2.29, P \u0026lt; 0.001; 360 days: HR = 1.88, 95% CI-= 1.61-2.20, P \u0026lt; 0.001). According to the Kaplan-Meier results, patients with higher SIRI had a significantly higher risk of all-cause mortality (P \u0026lt; 0.001). In addition, restricted cubic spline analysis showed a J-shaped (J-shaped) nonlinear relationship between SIRI and all-cause mortality in patients with heart failure. Subgroup analyses showed that SIRI did not interact with most subgroups, but the effect of SIRI on mortality was greater in the non-sepsis group.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSIRI was significantly associated with short-and long-term all-cause mortality in patients with heart failure and may become a predictor of prognosis in heart failure patients in the future.\u003c/p\u003e","manuscriptTitle":"Association between systemic inflammatory response index (SIRI) and all-cause mortality in patients with heart failure: a retrospective analysis based on the largescale clinical database MIMIC-IV","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-18 09:55:09","doi":"10.21203/rs.3.rs-7035962/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6c9dd0c1-66ec-4ede-ab0c-c7b343f880e4","owner":[],"postedDate":"July 18th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":51693940,"name":"Health sciences/Biomarkers"},{"id":51693941,"name":"Health sciences/Cardiology"},{"id":51693942,"name":"Health sciences/Diseases"},{"id":51693943,"name":"Health sciences/Medical research"},{"id":51693944,"name":"Health sciences/Risk factors"}],"tags":[],"updatedAt":"2025-12-08T17:38:44+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-18 09:55:09","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7035962","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7035962","identity":"rs-7035962","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}