住院患者全身免疫炎症指数与下肢深静脉血栓形成风险的相关性：一项10年回顾性分析
Association between systemic immune-inflammation index and risk of lower extremity deep venous thrombosis in hospitalized patients: a 10-year retrospective analysis.
作者信息
Chen Xi, Ou Yili, Wang Zhicong, Liu Hailong, Liu Yuehong, Liu Mozhen
机构信息
Department of Orthopedics, People's Hospital of Deyang City, Deyang, China.
Department of Orthopedics, The First Affiliated Hospital of Dalian Medical University, Dalian, China.
出版信息
Front Cardiovasc Med. 2023 Jun 16;10:1211294. doi: 10.3389/fcvm.2023.1211294. eCollection 2023.
BACKGROUND
The systemic immune-inflammation index (SII), as a novel inflammatory biomarker, has recently attracted attention in cardiovascular disease research. However, the relationship between SII and risk of lower extremity deep venous thrombosis (LEDVT) remains unclear to date. Thus, this study aimed to explore the association in a large sample over a 10-year period (2012-2022).
METHODS
All hospitalized patients undergoing lower extremity compression ultrasonography (CUS) examination were consecutively screened by searching our hospital information system database. The receiver operating characteristic (ROC) curve analysis was used to identify the optimal cut-off value for high and low SII group. Multivariate logistic regression analyses were performed to investigate the relationship between SII and LEDVT risk. Propensity score matching (PSM), subgroup and sensitivity analyses were also conducted. Moreover, restricted cubic spline (RCS) regression and two-piecewise linear regression models were used to assess the dose-response relationship between natural log transformed SII [ln(SII)] and risk of LEDVT.
RESULTS
A total of 16,725 consecutive hospitalized patients were included, and 1,962 LEDVT events occurred. After adjusting for confounding factors, patients in the high SII group (≥ 574.2 × 10/L) showed a 1.740-fold risk of LEDVT (95% : 1.546-1.959, < 0.001), and elevated ln(SII) was associated with a 36.1% increased risk of LEDVT (95% : 1.278-1.449, < 0.001). PSM, subgroup and sensitivity analyses confirmed the robustness of the association. A non-linear relationship was observed ( < 0.001), with a threshold value of 5.6 × 10/L for all LEDVT events. Above the threshold, each unit increase in ln(SII) had a 1.369-fold higher risk of LEDVT (95% : 1.271-1.475, < 0.001). The association also existed in both distal and proximal LEDVT.
CONCLUSION
Elevated SII is significantly associated with an increased risk of LEDVT in hospitalized patients. Additionally, the association is non-linear and exhibit a threshold effect.
背景
全身免疫炎症指数（SII）作为一种新型炎症生物标志物，最近在心血管疾病研究中受到关注。然而，迄今为止，SII与下肢深静脉血栓形成（LEDVT）风险之间的关系仍不清楚。因此，本研究旨在探讨10年期间（2012 - 2022年）大样本中的这种关联。
方法
通过检索我院信息系统数据库，对所有接受下肢加压超声（CUS）检查的住院患者进行连续筛查。采用受试者工作特征（ROC）曲线分析确定高、低SII组的最佳截断值。进行多因素逻辑回归分析以研究SII与LEDVT风险之间的关系。还进行了倾向评分匹配（PSM）、亚组分析和敏感性分析。此外，使用受限立方样条（RCS）回归和两段式线性回归模型评估自然对数转换后的SII [ln(SII)]与LEDVT风险之间的剂量反应关系。
结果
共纳入16725例连续住院患者，发生1962例LEDVT事件。在调整混杂因素后，高SII组（≥574.2×10/L）患者发生LEDVT的风险为1.740倍（95%：1.546 - 1.959，P < 0.001），ln(SII)升高与LEDVT风险增加36.1%相关（95%：1.278 - 1.449，P < 0.001）。PSM、亚组分析和敏感性分析证实了这种关联的稳健性。观察到一种非线性关系（P < 0.001），所有LEDVT事件的阈值为5.6×10/L。高于阈值时，ln(SII)每增加一个单位，发生LEDVT的风险高1.369倍（95%：1.271 - 1.475，P < 0.001）。这种关联在远端和近端LEDVT中均存在。
结论
住院患者中SII升高与LEDVT风险增加显著相关。此外，这种关联是非线性的，且呈现阈值效应。
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