Department of General Medicine, Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, People's Republic of China.
Department of Respiratory Medicine, Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, People's Republic of China.
Int J Chron Obstruct Pulmon Dis. 2024 Feb 19;19:459-473. doi: 10.2147/COPD.S446364. eCollection 2024.
Chronic obstructive pulmonary disease (COPD) concurrent with respiratory failure (RF) is devastating, and may result in death and disability. Systemic immune-inflammation index (SII) is a new prognostic biomarker linked to unfavorable outcomes of acute coronary syndrome, ischemic stroke, and heart failure. Nonetheless, its role in COPD is rarely investigated. Consequently, this study intends to assess the accuracy of SII in predicting the prognosis of COPD.
The clinical information was retrospectively acquired from the Medical Information Mart for Intensive Care-IV database. The outcomes encompassed the incidence of RF and mortality. The relationship between different SII and outcomes was examined utilizing the Cox proportional-hazards model and restricted cubic splines. Kaplan-Meier analysis was employed for all-cause mortality.
The present study incorporated 1653 patients. During hospitalization, 697 patients (42.2%) developed RF, and 169 patients (10.2%) died. And 637 patients (38.5%) died during long-term follow-up. Higher SII increased the risk of RF (RF: HR: 1.19, 95% CI 1.12-1.28, P<0.001), in-hospital mortality (HR: 1.22, 95% CI 1.07-1.39, P=0.003), and long-term follow-up mortality (HR: 1.12, 95% CI 1.05-1.19, P<0.001). Kaplan-Meier analysis suggested a significantly elevated risk of all-cause death (log-rank P<0.001) in patients with higher SII, especially during the short-term follow-up period of 21 days.
SII is closely linked to an elevated risk of RF and death in COPD patients. It appears to be a potential predictor of the prognosis of COPD patients, which is helpful for the risk stratification of this population. However, more prospective studies are warranted to consolidate our conclusion.
慢性阻塞性肺疾病（COPD）合并呼吸衰竭（RF）具有破坏性，可导致死亡和残疾。系统性免疫炎症指数（SII）是一种新的预后生物标志物，与急性冠状动脉综合征、缺血性卒中和心力衰竭的不良结局相关。然而，其在 COPD 中的作用很少被研究。因此，本研究旨在评估 SII 预测 COPD 预后的准确性。
临床信息从重症监护 IV 医疗信息集市数据库中回顾性获得。结果包括 RF 发生率和死亡率。利用 Cox 比例风险模型和限制立方样条检查不同 SII 与结局之间的关系。Kaplan-Meier 分析用于全因死亡率。
本研究纳入 1653 例患者。住院期间，697 例（42.2%）发生 RF，169 例（10.2%）死亡。在长期随访中，有 637 例（38.5%）死亡。较高的 SII 增加了 RF（RF：HR：1.19，95%CI 1.12-1.28，P<0.001）、住院死亡率（HR：1.22，95%CI 1.07-1.39，P=0.003）和长期随访死亡率（HR：1.12，95%CI 1.05-1.19，P<0.001）的风险。Kaplan-Meier 分析表明，SII 较高的患者全因死亡风险显著增加（对数秩 P<0.001），尤其是在 21 天的短期随访期间。
SII 与 COPD 患者 RF 和死亡风险升高密切相关。它似乎是 COPD 患者预后的一个潜在预测指标，有助于对该人群进行风险分层。然而，需要更多的前瞻性研究来证实我们的结论。
