Practical Geriatrics

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Establishment of a predictive model for all-cause and cardiovascular mortality risk in elderly patients with hyperuricemia based on systemic inflammatory response syndrome 

  

  1. The First Medical Centre, Chinese PLA General Hospital, Beijing, 100853, China(ZHU Yue, ZHANG Honghong, WU Zhengfeng, ZHAO Haifeng); Department of Hepatology, Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China(GONG Shujuan); School of Medicine, Nankai University, Tianjin 300071, China(ZHENG Li); Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing 100041, China(YANG Zeng’ao, LIU Yuqi)

  • Online:2025-05-19 Published:2025-05-19
  • Contact: LIU Yuqi, Email: ametuofo980869@163.com

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Abstract:

Objective To explore the relationship between systemic inflammatory response syndrome (SIRS) and all-cause as well as cardiovascular mortality in the elderly patients with hyperuricemia, and to develop an effective mortality risk prediction model based on SIRI to improve risk stratification and guide clinical personalized decision-making. Methods This is a prospective cohort study that included 1,997 elderly patients with hyperuricemia from the NHANES (1999-2010) database. First, univariate and multivariate Cox regression analysis was used to explore the relationship between SIRI and all-cause as well as cardiovascular mortality, and identify the key predictive factors. A corresponding risk prediction model was constructed. The model's performance was evaluated by internal validation and area under the curve (AUC). Additionally, X-tile software was used to determine the optimal cutoff for risk stratification.

Results During a median follow-up of 152 months, 1,131 participants died, of which 330 died from cardiovascular diseases. Elevated SIRI was independently associated with both all-cause mortality (HR=1.17, 95% CI: 1.13－1.22, P<0.001) and cardiovascular mortality (HR=1.44, 95% CI: 1.28－1.62, P<0.001). The prediction model based on SIRI showed good performance in predicting all-cause mortality (AUC=0.722) and cardiovascular mortality (AUC=0.797). Calibration curves and clinical decision curve analysis further validated the accuracy and clinical applicability of the model. Risk stratification analysis showed significant differences between the stratified groups (log-rank P<0.001). Conclusions SIRI is an independent predictor of all-cause and cardiovascular mortality in the elderly patients with hyperuricemia. The predictive model based on SIRI demonstrates good discriminative ability, accuracy, and clinical decision-making value, which can aid in personalized risk assessment and guide clinical decision-making.

Key words: systemic inflammatory response syndrome, aged, hyperuricemia, all-cause mortality, cardiovascular mortality