Wijeratne Tissa, Crewther Sheila G, Wijeratne Chanith, Shao Richard
Department of Neurology, Western Health, La Trobe University, St. Albans, AUS.
Department of Neurology and Stroke Services, Australian Institute for Musculoskeletal Science, Sunshine Hospital, St. Albans, AUS.
Cureus. 2024 Aug 20;16(8):e67299. doi: 10.7759/cureus.67299. eCollection 2024 Aug.
This case report presents a novel exploration of serial systemic immune-inflammation indices (SSIIi) as a potential prognostic biomarker in a critical care setting. The subject of this report is a 31-year-old male who, following a heroin overdose, suffered an asystolic cardiac arrest and subsequently passed away two weeks later in the intensive care unit (ICU). The SSIIi, calculated as platelet count × neutrophil count / lymphocyte count, was monitored throughout his stay. The case demonstrates that SSIIi measurements, particularly within the critical initial 24-72 hours, may provide insight into the patient's immune response dynamics following a severe hypoxic event. Specifically, the data suggest that a persistently elevated SSIIi may be indicative of a maladaptive immune response, characterized by ongoing inflammation, which correlates with a deteriorating clinical trajectory. The rapid escalation and sustained high SSIIi values observed in this patient appear to predict a poor outcome. This case underscores the importance of SSIIi as a potential tool for clinicians to assess prognosis in ICU patients, particularly in cases of acute brain injury where hypoxia is a central factor and sepsis is not present. The findings open avenues for further research into SSIIi as an objective measure for guiding treatment decisions and improving outcomes in similar critical care scenarios.
本病例报告对连续系统性免疫炎症指数（SSIIi）作为重症监护环境中潜在的预后生物标志物进行了全新探索。本报告的对象是一名31岁男性，他在海洛因过量服用后发生心脏停搏，随后在重症监护病房（ICU）两周后死亡。在他住院期间持续监测SSIIi，其计算方法为血小板计数×中性粒细胞计数/淋巴细胞计数。该病例表明，SSIIi测量，尤其是在关键的最初24至72小时内，可能有助于深入了解严重缺氧事件后患者的免疫反应动态。具体而言，数据表明，持续升高的SSIIi可能表明存在适应不良的免疫反应，其特征为持续炎症，这与临床病程恶化相关。在该患者中观察到的SSIIi值迅速升高并持续处于高位，似乎预示着预后不良。本病例强调了SSIIi作为临床医生评估ICU患者预后的潜在工具的重要性，尤其是在急性脑损伤且不存在脓毒症的情况下，缺氧是核心因素。这些发现为进一步研究SSIIi作为指导治疗决策和改善类似重症监护情况预后的客观指标开辟了道路。
