Relationship between Advanced lung cancer inflammation index and all-cause and cause-specific mortality among Chronic Inflammatory Airway Diseases patients: a population-based study

Zhuanbo Luo^*Peixu ChenShiyu ChenXue KongChao Cao

• Ningbo First Hospital, Ningbo, China

Background: Chronic inflammatory airway diseases pose a significant threat to public health, with its prognosis closely tied to the body's inflammation level and nutritional status. As a composite indicator, the advanced lung cancer inflammation index integrates inflammation and nutritional status. Despite its potential utility, the link between ALI and the prognosis of patients with CIAD remains unexplored.This study aimed to investigate this relationship.We gathered data from the NHANES from 2013 to 2018. Kaplan-Meier analysis was employed to investigate the relationships between ALI and all-cause and cause-specific mortality in patients with CIAD. weighted univariable and multivariable Cox proportional hazards models were employed to further examine their relationship.Multiple factors that could impact the results were adjusted in the analysis. We also utilized a restricted cubic spline analysis to estimate the non-linear relationships between ALI and all-cause and cause-specific mortality rates in patients with CIAD. An elevated ALI was significantly related to a decreased risk of all-cause mortality, as well as mortality from cardiovascular and respiratory diseases among CIAD patients. Results from RCS analysis revealed a reverse J-shaped non-linear association between ALI and all-cause mortality in CIAD patients, with an inflection point at 99.The inflection point in the J-shaped relationship represents the ALI value with the lowest risk of mortality. Conversely, if ALI exceeded 99, a 10-unit increase in ALI resulted in a 3% rise in the risk of all-cause mortality. These findings were consistent across sociodemographic and prior disease-related subgroups, and remained stable in sensitivity analyses.This study revealed a novel association between elevated ALI level and reduced all-cause and cause-specific mortality risk in patients with CIAD.Furthermore, the relationship between ALI and mortality rates from all cause, as well as cardiovascular and respiratory diseases, exhibited an non-linear, J-shaped curve.These findings underscore the importance of maintaining optimal ALI levels within a specific range to promote long-term survival in CIAD patients. The dynamic variation in ALI over time also can help clinicians establish personalized ALI standards to maximize the long-term outcomes for CIAD patients.