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全身免疫炎症指数对行单纯二尖瓣置换术的非功能性二尖瓣反流患者预后的影响

Effect of Systemic Immune-Inflammation Index on Prognosis in Non-Functional Mitral Regurgitation Patients Undergoing Isolated Mitral Valve Replacement.

作者信息

Yuksel Busra Temel, Isık Mehmet, Tanyeli Omer, Yıldırım Serkan, GOrmus Niyazi

机构信息

Department of Cardiovascular Surgery, Şırnak State Hospital, Şırnak, Turkey.

Department of Cardiovascular Surgery, Necmettin Erbakan University Faculty of Medicine Hospital, Konya, Turkey.

出版信息

Braz J Cardiovasc Surg. 2025 Jun 18;40(4):e20230362. doi: 10.21470/1678-9741-2023-0362.

Abstract

OBJECTIVE

To investigate the effect of preoperative and postoperative systemic immune-inflammation index (SII) values on early prognosis in patients with nonfunctional mitral regurgitation etiology undergoing isolated mitral valve replacement (MVR).

METHODS

A total of 176 patients with isolated MVR performed from 2015 to 2021 were retrospectively investigated. The platelet, lymphocyte, and neutrophil counts were measured, and SII, neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR) values were calculated preoperatively and on the first and fourth days postoperatively. The correlations with postoperative 30-day early-term prognosis and mortality were investigated.

RESULTS

Mean age of the patients was 55.4 years, 69.9% were female, and 30.1% were male. At 30-day follow-up, 9% (n = 16) of patients died. There were significant positive correlations observed between age (P < 0.001), preoperative NLR (P = 0.003), preoperative SII (P = 0.02), and postoperative fourth day NLR (P < 0.001) values with 30-day mortality. Receiver operating characteristic analysis identified that age + preoperative SII (P < 0.001), age + preoperative NLR (P < 0.001), and age + postoperative fourth day NLR (P = 0.001) combinations were significant predictive factors for 30-day mortality. There was a significant positive correlation between postoperative fourth day SII value with intensive care unit (ICU) admission duration (P < 0.001, Ρ = 0.308).

CONCLUSION

For non-functional, isolated MVR patients, preoperative and postoperative fourth day SII and NLR values were found to provide an idea about 30-day prognosis. Additionally, patients with high postoperative fourth day SII values were observed to have longer ICU stays.

摘要

目的

探讨术前及术后全身免疫炎症指数(SII)值对单纯二尖瓣置换术(MVR)治疗的非功能性二尖瓣反流病因患者早期预后的影响。

方法

回顾性研究2015年至2021年期间共176例行单纯MVR的患者。测量血小板、淋巴细胞和中性粒细胞计数,并计算术前、术后第1天和第4天的SII、中性粒细胞/淋巴细胞比值(NLR)和血小板/淋巴细胞比值(PLR)值。研究其与术后30天早期预后和死亡率的相关性。

结果

患者平均年龄为55.4岁,女性占69.9%,男性占30.1%。在30天随访时,9%(n = 16)的患者死亡。年龄(P < 0.001)、术前NLR(P = 0.003)、术前SII(P = 0.02)和术后第4天NLR(P < 0.001)值与30天死亡率之间存在显著正相关。受试者工作特征分析确定年龄+术前SII(P < 0.001)、年龄+术前NLR(P < 0.001)和年龄+术后第4天NLR(P = 0.001)组合是30天死亡率的显著预测因素。术后第4天SII值与重症监护病房(ICU)住院时间之间存在显著正相关(P < 0.001,Ρ = 0.308)。

结论

对于非功能性、单纯MVR患者,术前及术后第4天的SII和NLR值可为30天预后提供参考。此外,观察到术后第4天SII值高的患者ICU住院时间更长。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f2ae/12175619/591af98e3189/bjcvs-40-04-e20230362-g01.jpg

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