This retrospective cohort included 725 patients undergoing open-chest cardiac surgery with cardiopulmonary bypass and evaluated preoperative pan-immune inflammation value (PIV) against KDIGO-defined postoperative acute kidney injury. Acute kidney injury occurred in 256 patients (35.3%). Each 50-unit higher PIV was associated with greater adjusted odds of acute kidney injury (odds ratio 1.04; 95% confidence interval 1.02–1.06). Adding PIV produced statistically significant but clinically modest improvements in integrated discrimination improvement and continuous net reclassification improvement, suggesting limited incremental predictive value despite the observed association.
Preoperative PIV was associated with postoperative acute kidney injury, but its incremental predictive contribution was clinically modest. These findings do not establish that PIV-guided care improves outcomes.
Study limitation: The retrospective observational design cannot establish causality, and the abstract does not report external validation of predictive performance.
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