Liang Lingbo, Su Qiaoli
General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China.
Biomol Biomed. 2025 Mar 7;25(4):798-809. doi: 10.17305/bb.2024.11494.
The systemic immune-inflammation index (SII) is a novel biomarker that reflects the balance between the host immune response and inflammation, two key pathophysiological processes involved in sepsis. This meta-analysis aimed to evaluate the relationship between SII at admission and short-term mortality in patients with sepsis. Literature searches were performed in PubMed, Embase, Web of Science, CNKI, and Wanfang up to August 30, 2024, using relevant search terms. Observational studies that reported the association between SII and short-term mortality in sepsis patients were included. Risk ratios (RRs) and 95% confidence intervals (CIs) comparing the incidence of mortality within 90 days in patients with sepsis with a high versus low SII were calculated. Nine cohort studies, with a total of 25,626 patients, were included. A high SII at admission was significantly associated with an increased risk of all-cause short-term mortality in sepsis patients (RR: 1.51, 95% CI: 1.31-1.67, P < 0.001), with moderate heterogeneity (I² = 43%). Sensitivity analyses confirmed the robustness of these findings. Subgroup analyses suggested a stronger association in patients younger than 67 years compared to those aged 67 years or older (P = 0.04), but no significant differences were observed based on sex, SII cutoff values, or follow-up duration. In conclusion, this meta-analysis demonstrates that elevated SII at admission is associated with an increased risk of short-term mortality in sepsis patients, particularly in younger individuals. Further research is needed to validate these findings and explore their clinical implications.
全身免疫炎症指数（SII）是一种反映宿主免疫反应与炎症之间平衡的新型生物标志物，炎症是脓毒症涉及的两个关键病理生理过程。本荟萃分析旨在评估脓毒症患者入院时的SII与短期死亡率之间的关系。截至2024年8月30日，使用相关检索词在PubMed、Embase、Web of Science、中国知网和万方数据库中进行了文献检索。纳入了报告脓毒症患者SII与短期死亡率之间关联的观察性研究。计算了高SII与低SII脓毒症患者90天内死亡率发生率的风险比（RR）和95%置信区间（CI）。纳入了9项队列研究，共25626例患者。入院时高SII与脓毒症患者全因短期死亡风险增加显著相关（RR：1.51，95%CI：1.31-1.67，P<0.001），异质性中等（I²=43%）。敏感性分析证实了这些发现的稳健性。亚组分析表明，与67岁及以上患者相比，67岁以下患者的关联更强（P=0.04），但在性别、SII临界值或随访时间方面未观察到显著差异。总之，本荟萃分析表明，入院时SII升高与脓毒症患者短期死亡风险增加相关，尤其是在年轻个体中。需要进一步研究来验证这些发现并探索其临床意义。
