系统免疫炎症指数（SII）和预后营养指数（PNI）对膝下截肢后死亡率的预测价值。
Predictive value of systemic immune inflammation index (SII) and prognostic nutritional index (PNI) on mortality after below-knee amputation.
机构信息
Kutahya Health Sciences University, Faculty of Medicine, Department of Orthopedics and Traumatology, Kütahya, Turkey.
出版信息
Medicine (Baltimore). 2023 Oct 27;102(43):e35703. doi: 10.1097/MD.0000000000035703.
This retrospective cross-sectional study aimed to evaluate the predictive value of SII (Systemic Immune Inflammation Index) and PNI (Prognostic Nutritional Index) with blood ratios on mortality in diabetic foot patients who underwent below-knee amputation. A total of 231 living (n = 71; 30.7%) and exitus (n = 160; 69.3%) patients were evaluated. The mortality group was divided into 3 groups: 30-day mortality (n = 62; 38.8%), 1-year mortality (n = 62; 38.8%), and over-1-year mortality (n = 36; 22.5%). The hemogram, SII, and PNI parameters of the patients were evaluated. Age, some blood count parameters and SII were significantly higher in the exitus group (P < .05). The lymphocyte, monocyte, eosinophil, albumin, and PNI levels were significantly higher in the living group (P < .05). Mortality was significantly predicted by age (B [regression coefficient] = 0.026, P < .05), NLR (neutrophil lymphocyte ratio) (B = -0.065, P < .05), PNI (B = -0.100, P < .01), and SII (B = 0.00000024, P < .01). The predictive values of CAR (C reactive protein albumin ratio), PNI, and SII were 77.3%, 77.0%, and 76.1%, respectively. For CAR of 30.88 cutoff value, the sensitivity and specificity were 79.4% and 64.8%, respectively. For the PNI 22.0143 cutoff value, the sensitivity and specificity were 66.9% and 5.6%, respectively. For the SII 732249.2481 cutoff value, the sensitivity and specificity were 91.9% and 31.0%, respectively. The predictive value of the PNI was significant for mortality time (B = 0.058; P < .01). The predictive value of PNI for 30-day mortality was significant (AUC (area under curve):0.632; P < .01), whereas its predictive value for 1-year mortality and over-1-year mortality after below-knee amputation was statistically insignificant (P > .05). Both the SII and PNI may be evaluated and used to predict mortality after below-knee amputation. The SII had a significant predictive value for 30-day mortality after below-knee amputation.
本回顾性横断面研究旨在评估 SII（全身免疫炎症指数）和 PNI（预后营养指数）与血液比值对接受膝下截肢的糖尿病足患者死亡率的预测价值。共评估了 231 名存活（n=71；30.7%）和死亡（n=160；69.3%）患者。死亡组分为 3 组：30 天死亡率（n=62；38.8%）、1 年死亡率（n=62；38.8%）和 1 年以上死亡率（n=36；22.5%）。评估了患者的血液常规、SII 和 PNI 参数。死亡组的年龄、一些血液计数参数和 SII 显著较高（P<.05）。存活组的淋巴细胞、单核细胞、嗜酸性粒细胞、白蛋白和 PNI 水平显著较高（P<.05）。年龄（B[回归系数] = 0.026，P<.05）、NLR（中性粒细胞淋巴细胞比）（B = -0.065，P<.05）、PNI（B = -0.100，P<.01）和 SII（B = 0.00000024，P<.01）显著预测了死亡率。CAR（C 反应蛋白白蛋白比）、PNI 和 SII 的预测值分别为 77.3%、77.0%和 76.1%。对于 30.88 的 CAR 截断值，敏感性和特异性分别为 79.4%和 64.8%。对于 PNI 22.0143 的截断值，敏感性和特异性分别为 66.9%和 5.6%。对于 SII 732249.2481 的截断值，敏感性和特异性分别为 91.9%和 31.0%。PNI 对死亡率时间（B=0.058；P<.01）的预测值具有显著意义。PNI 对 30 天死亡率的预测值有显著意义（AUC（曲线下面积）：0.632；P<.01），而对 1 年死亡率和膝下截肢后 1 年以上死亡率的预测值无统计学意义（P>.05）。SII 和 PNI 均可用于评估和预测膝下截肢后的死亡率。SII 对膝下截肢后 30 天死亡率有显著的预测价值。
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