Abstract

Background

Systemic pro-coagulatory and pro-inflammatory factors are critical factors in acute pulmonary embolism (APE). Recently the systemic immune-inflammation index (SII) has emerged as a new inflammatory and prognostic marker. We aimed to determine whether there is a relationship between SII and the severity of the APE. Methods. A total of 442 patients with APE, 202 women (45.7%) with an average age of 64 ± 16, were included in this retrospective observational study. APE severity was classified as massive (high risk), submassive (intermediate risk), and nonmassive (low risk). On admission, blood samples were collected for SII and other laboratory measurements. The SII was defined as platelet × neutrophil/lymphocyte counts. Results. SII levels were higher in patients with massive APE and gradually increased from nonmassive to massive APE (p < .001). SII was also significantly higher in patients with in-hospital death. Multivariable analysis showed that SII was an independent predictor for massive APE (Odds ratio 1.005 (95% CI 1.002–1.007), p < .001), together with C-reactive protein and cardiac troponin. In the receiver operating characteristic curve, the optimal cutoff value of SII to predict a massive APE was 1161, with 91% sensitivity and 90% specificity (area under the curve: 0.957). Conclusion. Our findings support an association between a higher SII level and a massive APE. As a simple biomarker, SII is an independent predictor of more severe disease in patients with APE. SII is a more powerful tool than traditional inflammatory markers for predicting the severity of disease in these patients

中文翻译：

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一种预测急性肺栓塞严重程度的新指标：全身免疫炎症指数

摘要

背景

全身性促凝和促炎因子是急性肺栓塞 (APE) 的关键因素。最近，全身免疫炎症指数 (SII) 已成为一种新的炎症和预后标志物。我们旨在确定 SII 与 APE 的严重程度之间是否存在关系。方法。这项回顾性观察研究共纳入 442 名 APE 患者，202 名女性（45.7%），平均年龄为 64 ± 16 岁。APE 严重程度分为大规模（高风险）、次大规模（中等风险）和非大规模（低风险）。入院时，采集血样用于 SII 和其他实验室测量。SII定义为血小板×中性粒细胞/淋巴细胞计数。结果. 大面积 APE 患者的 SII 水平较高，并从非大面积 APE 逐渐增加到大面积 APE ( p  < .001)。院内死亡患者的 SII 也显着升高。 多变量分析显示，SII与 C 反应蛋白和心肌肌钙蛋白一起是大规模 APE 的独立预测因子（优势比 1.005 (95% CI 1.002–1.007)，p < .001）。在受试者工作特征曲线中，SII 预测大量 APE 的最佳截止值为 1161，灵敏度为 91%，特异性为 90%（曲线下面积：0.957）。结论. 我们的研究结果支持较高的 SII 水平与大规模 APE 之间的关联。作为一种简单的生物标志物，SII 是 APE 患者更严重疾病的独立预测因子。SII 是一种比传统炎症标志物更强大的工具，可用于预测这些患者的疾病严重程度