The aggregate index of systemic inflammation (Aisi): A novel prognostic biomarker in idiopathic pulmonary fibrosis

Angelo Zinellu, Claudia Collu, Mouhamad Nasser, Panagiotis Paliogiannis, Sabrina Mellino, Elisabetta Zinellu, Julie Traclet, Kais Ahamad, Arduino Aleksander Mangoni, Ciriaco Carru, Pietro Pirina, Alessandro Giuseppe Fois, Vincent Cottin

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Variable patterns of disease progression are typically observed in patients with idiopathic pulmonary fibrosis (IPF). We sought to determine the prognostic capacity of blood cell count indexes, derived from routine complete blood cell (CBC) count, in a cohort of IPF patients. The neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI) were calculated at baseline in a consecutive series of 82 IPF patients followed for four years. After adjusting for age, gender, body mass index, smoking status, and disease stage, only the AISI was significantly associated with mortality (HR 1.0013, 95% CI 1.0003–1.0023, p = 0.015). Patients with AISI <434 and ≥434 had a median survival from the diagnosis of 35.3 ± 15.2 and 26.6 ± 16.3 months (p = 0.015), and a four-year survival rate of 54% and 34%, respectively. The AISI, easily derivable from routine laboratory tests, is independently associated with mortality in patients with IPF. Prospective studies in larger cohorts are required to confirm this association.

Original languageEnglish
Article number4134
Number of pages11
JournalJournal of Clinical Medicine
Issue number18
Publication statusPublished - Sept 2021


  • AISI
  • Complete blood cell count
  • Derived blood cell count
  • Idiopathic pulmonary fibrosis


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