Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, 610041, China.
Sci Rep. 2024 Sep 15;14(1):21535. doi: 10.1038/s41598-024-72447-3.
The systemic immune-inflammatory index (SII) has been identified as an independent prognostic factor for multiple diseases. However, the impact of SII on outcome of acute-on-chronic liver failure (ACLF) is scant. A retrospective study enrolled patients with ACLF treated with artificial liver support system. Restricted cubic spline (RCS) (knots at the 10th, 50th, and 90th percentiles) and Cox proportional hazards models were applied to investigate the relationship between SII and 90-day transplant-free survival and overall survival in patients with ACLF. A total of 258 patients with ACLF were included. The 90-day transplant-free survival rate and overall survival rate were 58.5% and 66.3%. The SII was 465.5 (277.3-804.4). Adjusted RCS models showed linear exposure-response relationship between SII and 90-day transplant-free survival (P for overall < 0.001, P for nonlinear = 0.154) and 90-day overall survival (P for overall < 0.001, P for nonlinear = 0.103), and adjusted Cox models confirmed the positive relationship. Compared with patients with SII < 480, patients with ≥ 480 had more serious condition, lower 90-day transplant-free survival rate (46.8% vs. 69.7%, adjusted HR (95% CI) for transplant or death: 2.13 (1.40-3.23), P < 0.001), and lower 90-day overall survival rate (56.3% vs. 75.8%; adjusted HR (95% CI) for death: 2.26 (1.42-3.61), P = 0.001). Stratified Cox models suggested no potential modifiers in the relationship between SII and 90-day transplant-free survival. Our findings suggested SII was positively associated with poor short-term prognosis of ACLF.
系统免疫炎症指数（SII）已被确定为多种疾病的独立预后因素。然而，SII 对慢加急性肝衰竭（ACLF）患者结局的影响尚不清楚。本回顾性研究纳入了接受人工肝支持系统治疗的 ACLF 患者。限制性立方样条（RCS）（在第 10、50 和 90 百分位数处的节点）和 Cox 比例风险模型用于研究 SII 与 ACLF 患者 90 天无移植存活率和总生存率之间的关系。共纳入 258 例 ACLF 患者。90 天无移植存活率和总生存率分别为 58.5%和 66.3%。SII 为 465.5（277.3-804.4）。调整后的 RCS 模型显示，SII 与 90 天无移植存活率（整体 P<0.001，非线性 P=0.154）和 90 天总生存率（整体 P<0.001，非线性 P=0.103）之间存在线性暴露-反应关系，调整后的 Cox 模型证实了这种正相关关系。与 SII<480 的患者相比，SII≥480 的患者病情更严重，90 天无移植存活率较低（46.8%比 69.7%，移植或死亡的调整 HR（95%CI）：2.13（1.40-3.23），P<0.001），90 天总生存率也较低（56.3%比 75.8%；死亡的调整 HR（95%CI）：2.26（1.42-3.61），P=0.001）。分层 Cox 模型表明，SII 与 90 天无移植存活率之间的关系中没有潜在的修饰因素。我们的研究结果表明，SII 与 ACLF 的短期预后不良呈正相关。
