1Faculty of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia.
2Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Muhammadiyah Prof. Dr. Hamka, Tangerang, Indonesia.
Rom J Intern Med. 2024 Apr 9;62(3):231-240. doi: 10.2478/rjim-2024-0016. Print 2024 Sep 1.
Acute pulmonary embolism (APE) is a life-threatening condition with a high mortality rate. The pathophysiology involves various complex processes. The systemic immune-inflammatory index (SII) is a well-known biomarker that reflects the intricate balance between pro-inflammatory and anti-inflammatory immune components. In this systematic review, we aim to determine the significance of SII as a potential biomarker for APE.
We utilized PubMed, ProQuest, EBSCOHost, and Google Scholar to search for articles. We assessed bias risk using the Newcastle Ottawa Scale (NOS). The outcomes we examined included in-hospital and long-term mortality, the severity of APE, and the sensitivity and specificity of the SII in predicting APE.
Four studies, involving 2,038 patients, were included for analysis. These studies discuss the use of SII in predicting APE severity, APE mortality, high-risk APE, and the occurrence of APE. SII demonstrates significant results in predicting each of these variables. Furthermore, each study establishes different SII cut-off values. Specifically, a cut-off of 1161 predicts massive APE events with a sensitivity of 91% and a specificity of 90%. A cut-off of >1235.35 differentiates high-risk APE with a sensitivity of 87.32% and a specificity of 68.85%. A cut-off of >1111x10 predicts overall mortality with a sensitivity of 72% and a specificity of 51%. Finally, a cut-off at 1839.91 predicts APE events with a sensitivity of 75.8% and a specificity of 61.9%.
The SII can be employed as a potential new biomarker to predict outcomes in APE patients, particularly the occurrence, severity, and mortality of APE.
急性肺栓塞（APE）是一种具有高死亡率的危及生命的病症。其病理生理学涉及多种复杂的过程。全身免疫炎症指数（SII）是一种众所周知的生物标志物，反映了促炎和抗炎免疫成分之间的复杂平衡。在这项系统评价中，我们旨在确定 SII 作为 APE 潜在生物标志物的意义。
我们使用 PubMed、ProQuest、EBSCOHost 和 Google Scholar 进行了文献检索。我们使用纽卡斯尔-渥太华量表（NOS）评估了偏倚风险。我们评估的结局包括院内和长期死亡率、APE 的严重程度以及 SII 预测 APE 的敏感性和特异性。
纳入了四项研究，共 2038 名患者。这些研究讨论了 SII 在预测 APE 严重程度、APE 死亡率、高危 APE 和 APE 发生中的应用。SII 在预测这些变量中的每一个都显示出显著的结果。此外，每个研究都建立了不同的 SII 截断值。具体而言，截断值为 1161 预测大面积 APE 事件的敏感性为 91%，特异性为 90%。截断值＞1235.35 区分高危 APE 的敏感性为 87.32%，特异性为 68.85%。截断值＞1111x10 预测总体死亡率的敏感性为 72%，特异性为 51%。最后，截断值为 1839.91 预测 APE 事件的敏感性为 75.8%，特异性为 61.9%。
SII 可作为预测 APE 患者结局的潜在新型生物标志物，特别是 APE 的发生、严重程度和死亡率。
