Association of the aggregate index of systemic inflammation in cancer survivors with all-cause, cardiovascular, and cancer-related mortality.

ABSTRACT:

Background

The relationship between the aggregate index of systemic inflammation (AISI) and the mortality risk of pan-cancer patients in the US population remains unclear. This study aimed to investigate the relationship between baseline AISI and all-cause mortality and specific types of mortality in adult cancer survivors in the United States.

Methods

We used the data from the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2018. A multivariate Cox regression analysis model was constructed to determine the relationship between baseline AISI and outcomes. Outcome events include all-cause, cardiovascular disease (CVD), and cancer-related mortality. Nonlinear correlations were analyzed via restricted cubic spline (RCS) analysis. Subgroup analysis and interaction tests were also conducted.

Results

A total of 3,773 adult cancer survivors were recruited in this study. Among them, 1,772 (42.99%) were male, with an average age of 62.83±14.32 years. The AISI was respectively divided into the quartiles (Q1-Q4) as follows: ≤179.23, 179.24-279.03, 279.04-442.59, and >442.59. During a median follow-up period of 87 months, 1,137 (30.14%) all-cause deaths occurred. Among these deaths, 314 were attributed to CVD and 343 to cancer. For every additional standard deviation increase in AISI, the risks of all-cause mortality, CVD mortality, and cancer-related mortality increased by 16% [hazard ratio (HR) =1.16, 95% confidence interval (CI): 1.12-1.21], 21% (HR =1.21, 95% CI: 1.14-1.29), and 9% (HR =1.09, 95% CI: 1.01-1.18), respectively. The RCS analysis results showed that the AISI index had a significant linear relationship with all-cause and CVD mortality. However, AISI showed a significant nonlinear relationship with cancer-related mortality (P for nonlinearity =0.01). Similar findings were also revealed in the subgroup analysis.

Conclusions

Elevated AISI is positively correlated with all-cause mortality in cancer survivors, and the AISI may thus serve as a valuable indicator of poor prognosis among cancer survivors.

SUBMITTER: Dong Y 

PROVIDER: S-EPMC12686166 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature