Prognostic Effect of the Aggregate Index of Systemic Inflammation (AlSl) on All-cause, Cardiovascular Mortality and Cause-Specific Mortality in Adult Cancer Patients

Background: Cancer is a leading global health concern, being the second top cause of death worldwide. This study examines the association between the Aggregate Index of Systemic Inflammation (AISI) and mortality in adult cancer patients. Methods: Data from the National Health and Nutrition Examination Survey (NHANES) were utilized to conduct Cox proportional-hazards models and generate Kaplan-Meier plots, facilitating the derivation of endpoint data and the identification of diverse survival patterns among participants diagnosed with cancer. Restricted cubic spline (RCS) transformations were employed to evaluate the dose-response relationship between the AISI and mortality in cancer patients. Subgroup interaction analysis was conducted to ascertain the predictive validity of the AISI within specific populations. Logistic regression analysis, along with stratification analysis, was applied to assess the association between the AISI and all-cause mortality among cancer patients. Results: A total of 2 253 subjects were included in this study from 1999 to 2018. Our results demonstrate that elevated quartiles of the AISI are significantly correlated with an increased risk of all-cause mortality and cardiovascular mortality (P<0.001). The predictive capability of AISI for both all-cause and cardiovascular mortality was substantiated, with c-indices of 0.82 and 0.81, respectively. AISI was positively associated with increased risk of all-cause mortality in cancer patients when combined with synergistic factors such as age, race, education, and history of diabetes. Conclusions: AISI is significantly associated with all-cause and cardiovascular mortality in cancer patients, highlighting systemic inflammation's role in prognosis. AISI could be a valuable prognostic marker, meriting further research into its mechanisms and implications for managing cancer patients.