Gao Fei, He Siqi, Li Jing, Wang Xiaoyue, Chen Xiaoting, Bu Xiaoning
Department of Respiratory and Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.
Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China.
J Inflamm Res. 2024 Sep 4;17:6051-6061. doi: 10.2147/JIR.S479214. eCollection 2024.
Systemic Immune-Inflammation Index (SII), calculated by (neutrophils count × platelet count)/lymphocytes count, is a novel index of the local immune response and systemic inflammation response. The SII has been shown to play an important role in the prognosis of many diseases, including cardiovascular diseases, cancer and COPD. However, its role in the prognosis of bronchiectasis remains unclear and requires further investigation. This study aimed to investigate the association between SII and readmissions in patients with acute exacerbations of bronchiectasis.
We conducted a retrospective cohort study of all bronchiectasis patients admitted to the respiratory ward in Beijing Chaoyang Hospital from January 2020 to January 2022. Patients were classified into four groups according to the quartiles of log(SII) at admission. The primary endpoint was readmission at 1-year follow up. Univariate and multivariate cox regression models were applied to investigate the relationship between SII and readmissions at 1-year follow up in patients with bronchiectasis.
A total of 521 patients were included in our study. The median (IQR) SII at admission were 506.10 (564.84). Patients with higher SII tended to be older, male, past and current smokers, have lower BMI, and more dyspnea symptoms. They also had higher inflammatory markers and received a greater spectrum of antibiotics and more intravenous glucocorticoids. Higher SII at admission were independently associated with readmission in patients with acute exacerbations for bronchiectasis following confounder adjustment (OR =1.007; 95% CI, 1.003-1.011; p <0.001).
Patients with elevated SII levels were typically older males, often smokers, with lower BMI and increased dyspnea. They received more antibiotics and intravenous glucocorticoids. Higher SII at admission are associated with readmission in patients with acute exacerbations of bronchiectasis. SII has potential clinical value as a predictive biomarker for clinical outcomes in bronchiectasis, offering a valuable tool for management strategies.
全身免疫炎症指数（SII）通过（中性粒细胞计数×血小板计数）/淋巴细胞计数计算得出，是一种反映局部免疫反应和全身炎症反应的新型指标。SII已被证明在包括心血管疾病、癌症和慢性阻塞性肺疾病等多种疾病的预后中发挥重要作用。然而，其在支气管扩张症预后中的作用仍不明确，需要进一步研究。本研究旨在探讨SII与支气管扩张症急性加重患者再入院之间的关联。
我们对2020年1月至2022年1月在北京朝阳医院呼吸病房住院的所有支气管扩张症患者进行了一项回顾性队列研究。根据入院时log(SII)的四分位数将患者分为四组。主要终点是1年随访时的再入院情况。采用单因素和多因素cox回归模型研究SII与支气管扩张症患者1年随访时再入院之间的关系。
我们的研究共纳入521例患者。入院时SII的中位数（IQR）为506.10（564.84）。SII较高的患者往往年龄较大、为男性、既往和当前吸烟者、BMI较低且呼吸困难症状较多。他们还具有较高的炎症标志物，接受更广泛的抗生素治疗和更多的静脉糖皮质激素治疗。在调整混杂因素后，入院时较高的SII与支气管扩张症急性加重患者的再入院独立相关（OR =1.007；95%CI，1.003 - 1.011；p <0.001）。
SII水平升高的患者通常为老年男性，常为吸烟者，BMI较低且呼吸困难增加。他们接受更多的抗生素和静脉糖皮质激素治疗。入院时较高的SII与支气管扩张症急性加重患者的再入院相关。SII作为支气管扩张症临床结局的预测生物标志物具有潜在的临床价值，为管理策略提供了有价值的工具。
