Wang Xueqing, Zhang Sheng, Wang Xinxin, Shen Xiaojun, Huang Lei
Department of Intensive Care Unit (ICU), Peking University Shenzhen Hospital, Shenzhen, Guangdong, 518036, People's Republic of China.
Vasc Health Risk Manag. 2025 May 5;21:345-360. doi: 10.2147/VHRM.S523798. eCollection 2025.
The incidence of heart failure (HF) remains high throughout the world, posing a serious threat to human health, with inflammation being a pivotal factor in the entire pathophysiologic process. Systemic inflammatory response index (SIRI) and systemic immune inflammation index (SII) are novel indicators for poor prognosis of HF. This paper aimed to ascertain the connection between SIRI and mortality in critically ill HF patients and to compare the prognostic value with SII.
All data on HF patients were sourced from MIMIC-IV. Cox proportional hazards analysis, restricted cubic spline, and Kaplan-Meier survival analysis were utilized to determine the link between SIRI or SII and in-hospital mortality. Receiver operating characteristic curve, area under the curve (AUC), and Youden index were employed to compare the prognostic value of SIRI and SII. Subgroup analysis was conducted to confirm the predictive capability of SIRI on mortality. Propensity score matching was utilized to reveal the connection between SIRI and secondary outcomes.
754 patients were included and 45 patients (6.0%) died. There was a positive link between SIRI and in-hospital mortality in both unadjusted ( < 0.001) and adjusted models ( < 0.001 and = 0.001, respectively), outperforming SII in all models ( > 0.05 in all models). SIRI had a higher AUC and Youden index than SII, indicating better prognostic power. In addition, hospital stay was shorter in the low SIRI group ( = 0.034).
SIRI predicts in-hospital mortality in critically ill HF patients, and the prognostic power is superior to SII.
心力衰竭（HF）在全球的发病率仍然很高，对人类健康构成严重威胁，炎症是整个病理生理过程中的关键因素。全身炎症反应指数（SIRI）和全身免疫炎症指数（SII）是HF预后不良的新指标。本文旨在确定SIRI与重症HF患者死亡率之间的联系，并与SII比较其预后价值。
所有HF患者的数据均来自MIMIC-IV。采用Cox比例风险分析、限制性立方样条分析和Kaplan-Meier生存分析来确定SIRI或SII与院内死亡率之间的联系。采用受试者工作特征曲线、曲线下面积（AUC）和尤登指数来比较SIRI和SII的预后价值。进行亚组分析以确认SIRI对死亡率的预测能力。采用倾向评分匹配来揭示SIRI与次要结局之间的联系。
纳入754例患者，45例（6.0%）死亡。在未调整模型（<0.001）和调整模型（分别为<0.001和=0.001）中，SIRI与院内死亡率均呈正相关，在所有模型中均优于SII（所有模型中>0.05）。SIRI的AUC和尤登指数高于SII，表明其预后能力更好。此外，低SIRI组的住院时间较短（=0.034）。
SIRI可预测重症HF患者的院内死亡率，且预后能力优于SII。
