The Role of SII and SIRI Values in Predicting the Severity of CO Poisoning in the Emergency Department

Abstract

Aim: In this study, the role of indices based on hematological parameters measured at admission in predicting the severity of carbon monoxide poisoning (COZ) was investigated. Methods: A total of 183 patients, who were diagnosed with COZ in the emergency department of a Training and Research hospital between 2018 and 2022 were retrospectively analyzed. COHb and lactate levels were used to determine the clinical severity of the patients. The patients were divided into two groups as mild-moderate carbon monoxide poisoning (mild-moderate COZ) and severe carbon monoxide poisoning (severe COZ). Two groups were compared for systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), aggregate index of systemic inflammation (AISI), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and monocyte/lymphocyte ratio (MLR). Results: There was a significant difference between groups with regard to SII, SIRI, AISI, NLR, PLR and MLR (p<0.001, for all). According to the ROC analysis in the estimation of severe COZ, when SII cut-off value was >1519.14, the sensitivity was 67.9% and the specificity was 63.7% (AUC: 0.708, p<0.001). When SIRI cut-off value was >4.955, the sensitivity was 60% and the specificity was 78.5% (AUC:0.746, p<0.001). According to logistic regression analysis, NLR, PLR, MLR, SII, SIRI and AISI values were independent predictors of severity of COZ. Conclusion: SII, SIRI, AISI, NLR, PLR and MLR levels measured at admission in COZ patients are associated with the severity of poisoning. These markers can be used to predict the severity of inflammation.

Keywords

• carbon monoxide poisoning;
• systemic immune-inflammation index;
• systemic inflammatory response index;
• emergency department
• Karbonmonosit zehirlenmesi
• sistemik immün inflamasyon indeksi;
• sistemik inflamatuar cevap indeksi;
• acil servis

Project Number

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Acil Serviste SII ve SIRI değerlerinin CO Zehirlenmesinin Şiddetini Tahmin Etmedeki Rolü

Abstract

Amaç: Bu çalışmada, başvuru sırasında ölçülen hematolojik parametrelere dayalı indeklerin karbonmonoksit zehirlenmesinin (COZ) şiddetini tahmin etmedeki rolü araştırıldı. Gereç ve yöntem: 2018 ve 2022 tarihleri arasında bir Eğitim ve Araştırma hastanesi acil servisinde COZ tanısı konulan toplam 183 hasta retrospektif olarak incelendi. Hastaların klinik şiddetini belirlemek için COHb ve laktat düzeyleri kullanıldı. Hastalar hafif-orta karbon monoksit zehirlenmesi (hafif-orta COZ) ve ciddi karbon monoksit zehirlenmesi (ciddi COZ) olarak iki gruba ayrıldı. Sistemik immün inflamasyon indeksi (SII), sistemik inflamatuar cevap indeksi (SIRI) ve sistemik inflamasyon toplam indeksi (AISI), nötrofil/lenfosit oranı (NLR), platelet/lenfosit oranı (PLR) ve monosit/lenfosit oranı (MLR) bu iki hasta grubu arasında karşılaştırıldı. Bulgular: SII, SIRI, AISI, NLR, PLR ve MLR açısından her iki grup arasında önemli farklılık vardı (p<0.001, hepsi için). Ciddi COZ tahmininde ROC analizine göre, SII cut-off değeri >1519.14 iken, sensitivite %67.9 ve spesifite %63.7 idi (AUC: 0.708, p<0.001). SIRI cut-off değeri >4.955 iken, sensitivite %60 ve spesifite %78.5 olarak bulundu (AUC:0.746, p<0.001). Lojistik regresyon analizine göre, COZ’un ciddiyet tahmininde NLR, PLR, MLR, SII, SIRI ve AISI değerleri bağımsız öngörücülerdi. Sonuç: COZ hastalarında başvuru anında ölçülen SII, SIRI, AISI, NLR, PLR ve MLR seviyeleri zehirlenmenin ciddiyeti ile ilişkilidir ve inflamasyonun şiddetini öngörmede kullanılabilecek belirteçlerdir.

Keywords

• Karbonmonosit zehirlenmesi
• sistemik immün inflamasyon indeksi;
• sistemik inflamatuar cevap indeksi;
• acil servis

Supporting Institution

yok

Project Number

yok

Thanks

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