ORIGINAL RESEARCH article
Front. Physiol.
Sec. Respiratory Physiology and Pathophysiology
Volume 16 - 2025 | doi: 10.3389/fphys.2025.1570988
Between Endothelial Activation and Stress Index (EASIX) and mortality in Acute Respiratory Distress Syndrome (ARDS) patients: a multicenter retrospective study
Provisionally accepted
- Department of Pulmonary and Critical Care Medicine, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
The Endothelial Activation and Stress Index (EASIX), calculated as [lactate dehydrogenase (U/L) × creatinine (mg/dL)] ÷ platelet count (109/L), serves as a reliable biomarker for endothelial dysfunction. Endothelial damage significantly contributes to the pathophysiological mechanisms underlying acute respiratory distress syndrome (ARDS). However, the relationship between EASIX and ARDS patients remains to be fully elucidated.To evaluate the relationship between EASIX and outcomes in patients with acute respiratory distress syndrome (ARDS), in two cohorts we used Cox proportional hazards models and applied restricted cubic spline methods. Then we stratify EASIX into higher Log2_EASIX and lower Log2_EASIX groups, matched baseline data from the two stratified groups in both cohorts using propensity score matching to reduce confounding bias. Additionally, we further analyzed the differences in clinical outcomes between the higher Log2_EASIX and lower Log2_EASIX groups and performed Kaplan-Meier analysis on the matched data.In the MIMIC-IV cohort, compared to the survival group, within the 28 days, the non-survival group had higher Log2_EASIX (Survival: Non-survival = 1.35 [0.16, 2.80]: 2.08 [0.79, 3.59], P = 0.002),and in the CQMU cohort, the non-survival group had higher Log2_EASIX (Survival: Non-survival = 1. 91 [1.48, 2.43]: 2.34 [1.89, 3.01], P < 0.0001), Even after adjusting for potential confounders, individuals exhibiting elevated Log2_EASIX values still faced a greater risk of mortality during hospitalization and at 28-, 60-and 90-day post-admission.Conclusions: Elevated EASIX levels were found to be positively correlated with a higher risk of mortality in patients with ARDS. Assessing EASIX levels could be a promising biomarker for predicting overall survival in ARDS.
Keywords: Acute respiratory distress syndrome (ARDS), Endothelial Activation and Stress Index (EASIX), Intensive care units (ICU), Mortality, A multicenter retrospective study
Received: 17 Mar 2025; Accepted: 08 Sep 2025.
Copyright: © 2025 Chen, Lv, Liu, Dai and Deng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wang Deng, Department of Pulmonary and Critical Care Medicine, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.