Association of iron metabolism and electrolyte imbalance with 30-day mortality in asthma patients

This investigation pioneers a data-driven exploration into prognostic biomarker patterns by leveraging the MIMIC-IV critical care repository, focusing on asthma patients admitted to the Intensive Care Unit (ICU). Through a retrospective cohort design, we systematically quantify the prognostic relevance of iron metabolism indicators (such as ferritin and transferrin) and key electrolytes (including potassium, sodium, and calcium) in predicting 30-day mortality. Integrating classical statistical frameworks via univariable and multivariable logistic regression with state-of-the-art ensemble learning techniques (Random Forest and XGBoost), we present a comprehensive, multiscale analysis that bridges conventional biostatistical rigor with modern artificial intelligence approaches to uncover novel biomarker-mortality associations in ICU-managed asthma. Our results suggest that indicators linked with iron metabolism exhibit a significant correlation with mortality (OR = 1.19, 95% CI 1.13-1.26, p < 0 . 001 ), implying an interplay of ferroptosis and inflammatory pathways to the worsening of asthma. Increased potassium levels are identified as a pertinent component, although statistical significance is not achieved in the multivariable model (p = 0.133). The multivariable model that includes iron and electrolyte markers attains an AUC of 0.79, indicating reasonable predictive power. The findings indicate that integrating iron metabolism and electrolyte markers into clinical evaluations could enhance early risk stratification in asthma patients, facilitating more targeted therapies and potentially improving survival rates. • The study provides novel insights into the prognostic relevance of iron metabolism and electrolyte biomarkers in critically ill asthma patients. • The study provides a retrospective analysis integrating classical statistical modeling (univariable and multivariable logistic regression) with advanced machine learning techniques. • It is demonstrated that dysregulation in iron metabolism, particularly ferritin and transferrin, is significantly associated with increased 30-day mortality, suggesting a potential mechanistic role of ferroptosis and inflammation in asthma pathophysiology.