系统性免疫-炎症指数预测不停跳冠状动脉旁路移植术后机械通气时间延长和重症监护病房停留时间：一项单中心回顾性研究。
Systemic Immune-Inflammation Index Predicts Prolonged Mechanical Ventilation and Intensive Care Unit Stay After off-Pump Coronary Artery Bypass Graft Surgery: A Single-Center Retrospective Study.
机构信息
Department of Anesthesiology and Intensive Care, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia.
Department of Cardiothoracic and Vascular Surgery, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia.
出版信息
Vasc Health Risk Manag. 2023 Jun 28;19:353-361. doi: 10.2147/VHRM.S409678. eCollection 2023.
PURPOSE
Coronary artery disease (CAD) is the primary cause of mortality in developing countries. Off-pump coronary artery bypass grafting (OPCAB) offers more upside in revascularization by preventing cardiopulmonary bypass trauma and minimizing aortic manipulation. Even though cardiopulmonary bypass is not involved, OPCAB still causes a significant systemic inflammatory response. This study determines the prognostic values of the systemic immune-inflammation index (SII) towards perioperative outcomes in patients who underwent OPCAB surgery.
PATIENTS AND METHODS
This was a single-center retrospective study at the National Cardiovascular Center Harapan Kita, Jakarta, using secondary data from electronic medical records and medical record archives of all patients who underwent OPCAB from January 2019 through December 2021. A total of 418 medical records were obtained, and 47 patients were excluded based on the exclusion criteria. The values of SII were calculated from preoperative laboratory data of segmental neutrophil count, lymphocyte count, and platelet count. Patients were divided into two groups based on the SII cutoff value of 878.056 x 10/mm.
RESULTS
The baseline SII values of 371 patients were calculated, among which 63 (17%) patients had preoperative SII values of ≥878.057 x 10/mm. High SII values were a significant predictor of prolonged ventilation (RR 1.141, 95% CI 1.001-1.301) and prolonged ICU stay (RR 1.218, 95% CI 1.021-1.452) after OPCAB surgery. A positive correlation was observed between SII and hospital length of stay after OPCAB surgery. From the receiver operating characteristic curve analysis, SII predicted prolonged ventilation duration, with an area under the curve of 0.658 (95% CI 0.575-0.741, p = 0.001).
CONCLUSION
High preoperative SII values are capable of predicting prolonged mechanical ventilation and intensive care unit stay after OPCAB surgery.
目的
冠心病（CAD）是发展中国家死亡的主要原因。非体外循环冠状动脉旁路移植术（OPCAB）通过防止心肺转流创伤和最小化主动脉操作，为再血管化提供更多优势。即使不涉及心肺转流，OPCAB 仍会引起明显的全身炎症反应。本研究旨在确定全身免疫炎症指数（SII）对接受 OPCAB 手术患者围手术期结局的预后价值。
患者和方法
这是雅加达国家心血管中心哈兰潘基塔的单中心回顾性研究，使用 2019 年 1 月至 2021 年 12 月期间所有接受 OPCAB 手术患者的电子病历和病历档案中的二级数据。共获得 418 份病历，根据排除标准排除 47 名患者。SII 值是根据中性粒细胞计数、淋巴细胞计数和血小板计数的术前实验室数据计算得出的。根据 SII 截断值 878.056 x 10/mm 将患者分为两组。
结果
计算了 371 名患者的基线 SII 值，其中 63 名（17%）患者术前 SII 值≥878.057 x 10/mm。高 SII 值是 OPCAB 手术后通气时间延长（RR 1.141，95%CI 1.001-1.301）和 ICU 入住时间延长（RR 1.218，95%CI 1.021-1.452）的显著预测因素。SII 与 OPCAB 手术后的住院时间呈正相关。来自受试者工作特征曲线分析，SII 预测通气时间延长，曲线下面积为 0.658（95%CI 0.575-0.741，p=0.001）。
结论
术前高 SII 值能够预测 OPCAB 手术后机械通气时间延长和 ICU 入住时间延长。
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