Clinical value of systemic immune-inflammation index in assessing the severity and prognosis of sepsis

Abstract:

Objective：To investigate the clinical value of systemic immune-inflammation index（SII） in assessing disease severity and prognosis in patients with sepsis. Methods：A total of 57 patients with sepsis were enrolled as subjects. According to disease severity，these patients were divided into sepsis group with 30 patients and septic shock group with 27 patients；according to 28-day outcome，the patients were divided into survival group with 48 patients and death group with 9 patients. Related data were recorded at the time of admission to the intensive care unit，including SII，procalcitonin（PCT），Acute Physiology and Chronic Health Evaluation Ⅱ（APACHE Ⅱ） score，and Sequential Organ Failure Assessment（SOFA） score. The sepsis group and the septic shock group were com－pared in terms of SII，blood PCT，APACHE Ⅱ，and SOFA. Spearman analysis was used to investigate the correlation between these in－dices. The receiver operating characteristic（ROC） curve was used to analyze the clinical value of SII，PCT，APACHE Ⅱ，and SOFA in evaluating the prognosis of patients with sepsis. Results：The sepsis group had a significantly lower SII than the septic shock group{[391.62（343.18，492.00）]×109/L vs. [1 454.17（689.96，2 467.52）]×109/L，P<0.05}. The sepsis group had a lower blood PCT level than the septic shock group{[10.03（1.02，51.47）] ng/mL vs. [12.56（2.00，53.57）] ng/mL，P>0.05}. The death group had significantly higher SII，APACHEⅡ score，and SOFA score than the survival group（P<0.05），while there was no sig－nificant difference in blood PCT level between the two groups（P>0.05）. The Spearman correlation analysis showed that SII was posi－tively correlated with APACHEⅡ score（r=0.628，P=0.001） and that SII was positively correlated with SOFA score in the patients with sepsis（r=0.638，P=0.001）. The ROC curve analysis showed that SII had an area under the ROC curve（AUC） of 0.914（P<0.05），PCT had an AUC of 0.519（P>0.05），and APACHEⅡ and SOFA had an AUC of 0.868（P<0.05）；SII had a cut-off value of 0.743. Conclusion：SII helps with early evaluation of disease severity and prognosis in patients with sepsis.