Prognostic value of the systemic immune-inflammation index in patients with acute respiratory distress syndrome: A retrospective study
Background: Inflammation is critical in the etiology and progression of acute respiratory distress syndrome (ARDS). This study aims to rigorously assess the predictive capacity of systemic immune-inflammation index (SII) in determining the outcomes of patients with ARDS. Methods: Patient data were e...
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Elsevier
2024-02-01
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844024026008 |
| _version_ | 1797267711657508864 |
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| author | xiaodong pan Junnan Xu He Wu Jie Wang wanquan Kong |
| author_facet | xiaodong pan Junnan Xu He Wu Jie Wang wanquan Kong |
| author_sort | xiaodong pan |
| collection | DOAJ |
| description | Background: Inflammation is critical in the etiology and progression of acute respiratory distress syndrome (ARDS). This study aims to rigorously assess the predictive capacity of systemic immune-inflammation index (SII) in determining the outcomes of patients with ARDS. Methods: Patient data were extracted from version 2.2 of the Medical Information Mart for Intensive Care IV (MIMIC-IV). The Receiver Operating Characteristic (ROC) curve was deployed to determine the optimal cutoff value for the SII, facilitating the stratification of participants into distinct cohorts based on SII levels. The relationship between SII and survival outcomes was rigorously evaluated using Cox proportional hazards models. The association between SII and patient survival was rigorously examined using Cox proportional-hazard models. The impact of varying SII levels on mortality was quantitatively assessed through these models, with the results articulated as hazard ratios (HRs) and 95% confidence intervals (CIs). Three distinct models were formulated for this analysis: Model 1 employed univariate Cox regression to relate SII with mortality; Model 2 introduced adjustments for age and sex; and Model 3 extended these adjustments to include age, sex, race, SAPS II, APSIII, Hemoglobin, Albumin, Pneumonia, SpO2, and SBP. Results: Post-application of the inclusion criteria, a cohort of 976 eligible patients was delineated for detailed examination. Univariate analysis focusing on 30-day mortality within the SII ≥1694, the hazard ratio (HR) was 1.42 (95% confidence interval (CI): 1.11, 1.81). However, after adjusting for confounding factors such as age, sex, race, Simplified Acute Physiology Score II (SAPS II), Acute Physiology Score (APS) III, Hemoglobin, Albumin, Pneumonia, SpO2, and Systolic Blood Pressure (SBP), an SII value of ≥1694 was identified as an independent and significant risk factor for mortality in patients with ARDS, with an HR of 1.38 (95% CI: 1.08–1.77, P = 0.0016). This trend was consistent for 90-day and one-year mortality rates. Conclusions: SII surfaced as an autonomous determinant of mortality in ARDS patients, affirming its status as an accessible and dependable prognostic indicator for individuals newly diagnosed with this critical condition. Additional research is imperative to further elucidate the prognostic implications of SII in the therapeutic management of patients with ARDS. |
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| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
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| spelling | doaj.art-fb7fdae85f9f4cab99a68bef3e70791d2024-03-09T09:28:35ZengElsevierHeliyon2405-84402024-02-01104e26569Prognostic value of the systemic immune-inflammation index in patients with acute respiratory distress syndrome: A retrospective studyxiaodong pan0Junnan Xu1He Wu2Jie Wang3wanquan Kong4Emergency Department, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, ChinaEmergency Department, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, ChinaEmergency Department, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, ChinaDepartment of Endocrinology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, ChinaEmergency Department, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China; Corresponding author.Background: Inflammation is critical in the etiology and progression of acute respiratory distress syndrome (ARDS). This study aims to rigorously assess the predictive capacity of systemic immune-inflammation index (SII) in determining the outcomes of patients with ARDS. Methods: Patient data were extracted from version 2.2 of the Medical Information Mart for Intensive Care IV (MIMIC-IV). The Receiver Operating Characteristic (ROC) curve was deployed to determine the optimal cutoff value for the SII, facilitating the stratification of participants into distinct cohorts based on SII levels. The relationship between SII and survival outcomes was rigorously evaluated using Cox proportional hazards models. The association between SII and patient survival was rigorously examined using Cox proportional-hazard models. The impact of varying SII levels on mortality was quantitatively assessed through these models, with the results articulated as hazard ratios (HRs) and 95% confidence intervals (CIs). Three distinct models were formulated for this analysis: Model 1 employed univariate Cox regression to relate SII with mortality; Model 2 introduced adjustments for age and sex; and Model 3 extended these adjustments to include age, sex, race, SAPS II, APSIII, Hemoglobin, Albumin, Pneumonia, SpO2, and SBP. Results: Post-application of the inclusion criteria, a cohort of 976 eligible patients was delineated for detailed examination. Univariate analysis focusing on 30-day mortality within the SII ≥1694, the hazard ratio (HR) was 1.42 (95% confidence interval (CI): 1.11, 1.81). However, after adjusting for confounding factors such as age, sex, race, Simplified Acute Physiology Score II (SAPS II), Acute Physiology Score (APS) III, Hemoglobin, Albumin, Pneumonia, SpO2, and Systolic Blood Pressure (SBP), an SII value of ≥1694 was identified as an independent and significant risk factor for mortality in patients with ARDS, with an HR of 1.38 (95% CI: 1.08–1.77, P = 0.0016). This trend was consistent for 90-day and one-year mortality rates. Conclusions: SII surfaced as an autonomous determinant of mortality in ARDS patients, affirming its status as an accessible and dependable prognostic indicator for individuals newly diagnosed with this critical condition. Additional research is imperative to further elucidate the prognostic implications of SII in the therapeutic management of patients with ARDS.http://www.sciencedirect.com/science/article/pii/S2405844024026008Systemic immuno-inflammatory indexARDSMIMICMortality |
| spellingShingle | xiaodong pan Junnan Xu He Wu Jie Wang wanquan Kong Prognostic value of the systemic immune-inflammation index in patients with acute respiratory distress syndrome: A retrospective study Heliyon Systemic immuno-inflammatory index ARDS MIMIC Mortality |
| title | Prognostic value of the systemic immune-inflammation index in patients with acute respiratory distress syndrome: A retrospective study |
| title_full | Prognostic value of the systemic immune-inflammation index in patients with acute respiratory distress syndrome: A retrospective study |
| title_fullStr | Prognostic value of the systemic immune-inflammation index in patients with acute respiratory distress syndrome: A retrospective study |
| title_full_unstemmed | Prognostic value of the systemic immune-inflammation index in patients with acute respiratory distress syndrome: A retrospective study |
| title_short | Prognostic value of the systemic immune-inflammation index in patients with acute respiratory distress syndrome: A retrospective study |
| title_sort | prognostic value of the systemic immune inflammation index in patients with acute respiratory distress syndrome a retrospective study |
| topic | Systemic immuno-inflammatory index ARDS MIMIC Mortality |
| url | http://www.sciencedirect.com/science/article/pii/S2405844024026008 |
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