Karaçalılar M, Demir M
Department of Cardiovascular Surgery, Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey.
Eur Rev Med Pharmacol Sci. 2023 Feb;27(3):1016-1022. doi: 10.26355/eurrev_202302_31196.
Inflammation plays a pivotal role in heart valve disease (HVD). This study aimed at evaluating the prognostic value of systemic inflammation response index (SIRI) after valve replacement surgery.
The study enrolled 90 patients who underwent valve replacement surgery. SIRI was calculated using laboratory data on admission. Receiver operating characteristic (ROC) analysis was used to calculate the optimal cutoff values of SIRI for predicting mortality. Univariable and multivariable COX analysis was used to assess the relationship of SIRI with clinical outcomes.
5-year mortality rate was higher in SIRI ≥1.55 group than SIRI <1.55 group [16 (38.1%) vs. 9 (18.8%)]. In receiver operating characteristic analysis, the optimal cutoff values for SIRI were 1.55 (area under the curve 0.654, p: 0.025). Univariable analysis revealed that SIRI [OR: 1.41, 95%CI (1.13-1.75), p<0.001] was an independent predictor of 5-years mortality. Multivariable analysis revealed that glomerular filtration rate (GFR) [OR: 0.98, 95%CI (0.97-0.99)] was an independent predictor of 5-years mortality.
Although SIRI is a preferable parameter for the detection of long-term mortality, it failed to predict in-hospital and 1-year mortality. Larger multi-center studies are needed to investigate effect of SIRI on prognosis.
炎症在心脏瓣膜疾病（HVD）中起关键作用。本研究旨在评估瓣膜置换术后全身炎症反应指数（SIRI）的预后价值。
本研究纳入90例行瓣膜置换手术的患者。入院时利用实验室数据计算SIRI。采用受试者工作特征（ROC）分析计算SIRI预测死亡率的最佳临界值。采用单变量和多变量COX分析评估SIRI与临床结局的关系。
SIRI≥1.55组的5年死亡率高于SIRI<1.55组[16例（38.1%）对9例（18.8%）]。在受试者工作特征分析中，SIRI的最佳临界值为1.55（曲线下面积0.654，p：0.025）。单变量分析显示，SIRI[比值比（OR）：1.41，95%置信区间（CI）（1.13 - 1.75），p<0.001]是5年死亡率的独立预测因素。多变量分析显示，肾小球滤过率（GFR）[OR：0.98，95%CI（0.97 - 0.99）]是5年死亡率的独立预测因素。
尽管SIRI是检测长期死亡率的一个较好参数，但它无法预测住院期间和1年死亡率。需要开展更大规模的多中心研究来调查SIRI对预后的影响。
