{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:27:34Z","timestamp":1786494454524,"version":"build-2736575974"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":72,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Accurate prognostication remains essential for appropriate care planning in palliative care settings. The Aggregate Index of Systemic Inflammation (AISI) represents a comprehensive integration of four inflammatory cell populations, but its comparative prognostic value in palliative care has not been established. This retrospective cohort study analyzed 144 consecutive patients admitted to a palliative care unit between January 2020 and December 2024. We evaluated the prognostic performance of AISI, Systemic Inflammation Response Index (SIRI), Systemic Immune-Inflammation Index (SII), and Neutrophil-to-Lymphocyte Ratio (NLR) for predicting in-hospital mortality, intensive care unit admission, and mechanical ventilation requirement. Receiver operating characteristic curve analysis, multivariable Cox regression, and Kaplan-Meier survival analysis were performed. A total of 144 patients (mean age 75.4\u2009\u00b1\u200911.8 years; 85 male [59.0%]) were included. In-hospital mortality occurred in 99 patients (68.8%). AISI demonstrated the highest discriminatory capacity for mortality prediction with area under the curve 0.826 (95% CI: 0.754\u20130.898), significantly superior to NLR (0.734,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.003) and SII (0.768,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.042). Optimal AISI cutoff of 1850 yielded sensitivity 79.8% and specificity 77.8%. In multivariable analysis, AISI\u2009&gt;\u20091850 remained the strongest independent mortality predictor (adjusted HR 4.38, 95% CI: 2.41\u20137.96,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) after adjusting for established prognostic factors. Kaplan\u2013Meier analysis revealed median survival of 9 days versus 35 days for patients with AISI\u2009&gt;\u20091850 versus \u2264\u20091850 (log-rank\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). AISI also independently predicted intensive care unit admission (adjusted OR 3.96, 95% CI: 1.89\u20138.28,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) and mechanical ventilation requirement (adjusted OR 4.15, 95% CI: 1.98\u20138.69,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). AISI demonstrates superior prognostic value compared to conventional inflammatory markers in palliative care patients. This readily available, cost-effective biomarker enables robust risk stratification for mortality and critical care interventions. Integration of AISI into comprehensive prognostic assessments could enhance individualized care planning and optimize resource allocation in palliative care settings.\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-54886-2","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T10:04:46Z","timestamp":1780308286000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic value of the aggregate index of systemic inflammation in palliative care patients"],"prefix":"10.1038","volume":"16","author":[{"given":"Evren","family":"Ekingen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mete","family":"Ucdal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"key":"54886_CR1","doi-asserted-by":"crossref","unstructured":"V\u00e9lez-L\u00f3pez, A. et al. Community-Based Interventions in People with Palliative Care Needs: An Integrative Review of Studies from 2017 to 2022. Healthc. (Basel), 12(15). (2024).","DOI":"10.3390\/healthcare12151477"},{"issue":"1","key":"54886_CR2","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1186\/s12904-025-01696-4","volume":"24","author":"MY Fung","year":"2025","unstructured":"Fung, M. Y. et al. Prognostic models for survival predictions in advanced cancer patients: a systematic review and meta-analysis. BMC Palliat. Care. 24 (1), 54 (2025).","journal-title":"BMC Palliat. Care"},{"issue":"6","key":"54886_CR3","doi-asserted-by":"publisher","first-page":"74","DOI":"10.22514\/sv.2025.085","volume":"21","author":"BD Samedov","year":"2025","unstructured":"Samedov, B. D. et al. Evaluation of the prognostic value of systemic inflammation indexes in patients diagnosed with acute coronary syndrome in the emergency department. Signa Vitae. 21 (6), 74\u201385 (2025).","journal-title":"Signa Vitae"},{"key":"54886_CR4","doi-asserted-by":"crossref","unstructured":"Zinellu, A. et al. The Aggregate Index of Systemic Inflammation (AISI): A Novel Prognostic Biomarker in Idiopathic Pulmonary Fibrosis. J. Clin. Med., 10(18). (2021).","DOI":"10.3390\/jcm10184134"},{"key":"54886_CR5","doi-asserted-by":"publisher","first-page":"1552341","DOI":"10.3389\/fonc.2025.1552341","volume":"15","author":"Y Yang","year":"2025","unstructured":"Yang, Y. et al. Association of aggregate index of systemic inflammation with increased all-cause and cardiovascular mortality in female cancer patients. Front. Oncol. 15, 1552341 (2025).","journal-title":"Front. Oncol."},{"key":"54886_CR6","doi-asserted-by":"publisher","unstructured":"Nicoar\u0103, A. et al. Systemic Immune\u2013Inflammatory Index and Other Inflammatory Marker Variations in Oral Squamous Cell Carcinoma Management. Medicina 60 https:\/\/doi.org\/10.3390\/medicina60111840 (2024).","DOI":"10.3390\/medicina60111840"},{"key":"54886_CR7","first-page":"1","volume":"34","author":"F Karadeniz","year":"2023","unstructured":"Karadeniz, F., Karadeniz, Y. & Altunta\u015f, E. Systemic immune-inflammation index, and neutrophilto-lymphocyte and platelet-to-lymphocyte ratios can predict clinical outcomes in patients with acute coronary syndrome. Cardiovasc. J. Afr. 34, 1\u20137 (2023).","journal-title":"Cardiovasc. J. Afr."},{"key":"54886_CR8","doi-asserted-by":"publisher","unstructured":"Carollo, C. et al. Silent Inflammation, Loud Consequences: Decoding NLR Across Renal, Cardiovascular and Metabolic Disorders. Int. J. Mol. 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Support Care Cancer. 7 (3), 128\u2013133 (1999).","journal-title":"Support Care Cancer"},{"key":"54886_CR14","doi-asserted-by":"crossref","unstructured":"Xiu, J. et al. The aggregate index of systemic inflammation (AISI): a novel predictor for hypertension. Front. Cardiovasc. Med., Volume 10\u20132023. (2023).","DOI":"10.3389\/fcvm.2023.1163900"},{"key":"54886_CR15","doi-asserted-by":"publisher","first-page":"7057","DOI":"10.2147\/JIR.S481515","volume":"17","author":"Y Jiang","year":"2024","unstructured":"Jiang, Y. et al. Association Between the Aggregate Index of Systemic Inflammation and Clinical Outcomes in Patients with Acute Myocardial Infarction: A Retrospective Study. J. Inflamm. Res. 17, 7057\u20137067 (2024).","journal-title":"J. Inflamm. Res."},{"issue":"1","key":"54886_CR16","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1093\/rb\/rbw041","volume":"4","author":"GS Selders","year":"2017","unstructured":"Selders, G. S. et al. An overview of the role of neutrophils in innate immunity, inflammation and host-biomaterial integration. Regen Biomater. 4 (1), 55\u201368 (2017).","journal-title":"Regen Biomater."},{"key":"54886_CR17","doi-asserted-by":"crossref","unstructured":"Sharma, S., Tyagi, T. & Antoniak, S. Platelet in thrombo-inflammation: Unraveling new therapeutic targets. Front. Immunol., Volume 13\u20132022. (2022).","DOI":"10.3389\/fimmu.2022.1039843"},{"issue":"17","key":"54886_CR18","doi-asserted-by":"publisher","first-page":"5078","DOI":"10.7150\/jca.44440","volume":"11","author":"BB Xu","year":"2020","unstructured":"Xu, B. B. et al. Prognostic significance of combined Lymphocyte-monocyte Ratio and Tumor-associated Macrophages in Gastric Cancer Patients after Radical Resection. J. Cancer. 11 (17), 5078\u20135087 (2020).","journal-title":"J. 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Combined Blood Indexes of Systemic Inflammation as a Mirror to Admission to Intensive Care Unit in COVID-19 Patients: A Multicentric Study. J. Epidemiol. Glob Health. 12 (1), 64\u201373 (2022).","journal-title":"J. Epidemiol. Glob Health"},{"key":"54886_CR22","doi-asserted-by":"publisher","first-page":"e80","DOI":"10.1017\/S1478951525000021","volume":"23","author":"SQ Yoong","year":"2025","unstructured":"Yoong, S. Q. et al. Prognostic utility of Palliative Prognostic Index in advanced cancer: A systematic review and meta-analysis. Palliat. Supportive Care. 23, e80 (2025).","journal-title":"Palliat. 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