Department of Emergency, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.
Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, China.
PLoS One. 2024 Aug 29;19(8):e0306884. doi: 10.1371/journal.pone.0306884. eCollection 2024.
We proposed a link between the first systemic inflammatory response index (SIRI) and acute kidney injury (AKI), as well as the prognosis of pediatric patients in intensive care units (PICU).
This study comprised 5114 children from the pediatric-specific intensive care (PIC) database. SIRI was estimated as a neutrophil monocyte lymphocyte ratio. All patients were arbitrarily allocated to the training set (n = 3593) and the validation cohort (n = 1521) and divided into two groups depending on their SIRI levels. The diagnostic value of SIRI for pediatric ICU patients was subsequently determined using LASSO regression models.
After controlling for additional confounding variables in the training set, the higher SIRI value (≥ 0.59) had a greater risk of AKI (adjusted odds ratio, OR, 3.95, 95% confidence interval, 95%CI, 2.91-5.36, P<0.001) and in-hospital mortality (hazard ratio, HR, 5.01, 95%CI 2.09-12.03, P<0.001). Similar findings were discovered in the validation set. Furthermore, the suggested nomogram derived from SIRI and other clinical metrics showed outstanding calibration capability as well as therapeutic usefulness in both groups.
SIRI is a reliable and useful factor for AKI and fatality in pediatric ICU patients, and the proposed nomogram based on SIRI yields an appropriate prediction value for critically sick pediatric patients.
我们提出了第一个全身性炎症反应指数（SIRI）与急性肾损伤（AKI）之间的联系，以及重症监护病房（PICU）儿科患者的预后。
本研究纳入了儿科特定重症监护（PIC）数据库中的 5114 名儿童。SIRI 估计为中性粒细胞-单核细胞-淋巴细胞比值。所有患者被任意分配到训练集（n=3593）和验证队列（n=1521），并根据 SIRI 水平分为两组。随后使用 LASSO 回归模型确定 SIRI 对儿科 ICU 患者的诊断价值。
在训练集中控制了其他混杂变量后，较高的 SIRI 值（≥0.59）发生 AKI（调整后的优势比，OR，3.95，95%置信区间，95%CI，2.91-5.36，P<0.001）和院内死亡率（风险比，HR，5.01，95%CI 2.09-12.03，P<0.001）的风险更高。在验证集中也发现了类似的结果。此外，基于 SIRI 和其他临床指标的建议列线图在两组中均显示出出色的校准能力和治疗效果。
SIRI 是儿科 ICU 患者 AKI 和死亡率的可靠且有用的因素，基于 SIRI 的建议列线图对重病儿科患者具有适当的预测价值。
