Systemic inflammatory response index (SIRI) and Systemic immune-inflammation index (SII) to show Thrombus Localization in Patients with Acute Pulmonary Embolism

Öz

Pulmonary embolism (PE) is a critical disease associated with mortality. Considerable markers related to this disease associated with inflammation have been used to catch thrombus localization. In this study, we wanted to examine the association between the Systemic inflammatory response index (SIRI), Systemic immune-inflammation index (SII) and thrombus localization in patients with PE. Our study consisted of patients diagnosed with PE between January 2020- June 2022. Laboratory parameters of patients diagnosed with PE, especially thrombus localization, thrombus location, SII, and SIRI, were recorded and compared with thrombus localization. One hundred patient with PE who met the inclusion criteria was incorporated in our study. When we grouped the patients according to PE localization, the thrombus was in the main pulmonary vein in 18%, in the lobar region in 51%, and in the distal pulmonary vein in 31% of the patients. In addition, mean SIRI and SII levels were encountered to be higher in patients with main pulmonary localization compared to those with thrombus in both lobar and segmental branches. SIRI has 78% sensitivity, and 72% specificity at the optimum cut-off value; in Level II, it detects thrombus with main pulmonary involvement with 66.7% sensitivity and 79.3% specificity. In patients with PE, high SII and SIRI values can be practical markers in predicting proximal thrombus.

Anahtar Kelimeler

• Pulmonary Embolism
• Systemic inflammatory response index
• Systemic immune-inflammation index

Akut Pulmoner Embolili Hastalarda Trombüs Lokalizasyonunu göstermede sistemik immün İnflamatuvar indeks ve sistemik inflamatuvar yanıt indeks

Öz

Pulmoner emboli (PE) mortalite ile de ilişkili önemli bir hastalıktır. İnflamasyon ile ilişkili olan bu hastalıkla ilgili birçok marker trombüs lokalizasyonu saptamak için kullanılmıştır. Biz bu çalışmada Systemic inflammatory response index (SIRI) ve Systemic immune-inflammation index (SII) ile PE li hastalardaki trombüs lokalizasyonu arasındaki ilişkiyi incelemek istedik. Çalışmamız Ocak 2020- Haziran 2022 yılları aranda PE tanısı alan hastalardan oluşmaktaydı. PE tanısı alan hastalar trombüs lokalizasyonu, trombüs yerleşkesi, SII ve SIRI başta olmak üzere labaratuar parametreleri kaydedilmiş ve trombüs lokalizasyonu ile karşılaştırılmıştır. Çalışmamıza dahil edilme kriterlerini sağlayan 100 PE li hasta katılmıştır. Hastalarının PE lokalizasyonuna göre grupladığımızda trombüs %18 inde ana pulmoner, %51 hastada lober bölgede iken, %31 inde ise distal pulmoner damardaydı. Ayrıca ortalama SIRI ve SII düzeyleri ana pulmoner lokalizayonu olanlarda hem lober hem de segmental dallarda trombüsü olanlara göre yüksek saptanmıştır. Optimum cut off değerinde SIRI %78 sensitivite, %72 spesifite; SII da %66.7 sensitivite, %79.3 spesifite ile ana pulmoner tutulumu olan trombüsü saptamaktadır. PE li hastalarda yüksek SII ve SIRI değerleri ile proksimal yerleşimli trombüsü tahmin etmede yararlı bir belirteç olabilir.

Anahtar Kelimeler

• Pulmoner Emboli
• Sistemik inflamatuar yanıt indeksi
• Sistemik immün-inflamasyon indeksi

Kaynakça

1. 1. Freund Y, Cohen-Aubart F, Bloom B. Acute Pulmonary Embolism: A Review. Jama. 2022;328:1336-45.
2. 2. Korkut M, Bedel C, Erman K, Yüksel S. Incidental findings of computed tomography angiography in patients suspected to pulmonary embolism; a brief report. Arch Acad Emerg Med. 2019;7:e60.
3. 3. Van Maanen R, Trinks-Roerdink EM, Rutten FH, Geersing GJ. A systematic review and meta-analysis of diagnostic delay in pulmonary embolism. Eur J Gen Pract. 2022;28:165-72.
4. 4. Bedel C, Korkut M, Armağan HH. Can NLR, PLR and LMR be used as prognostic indicators in patients with pulmonary embolism? A commentary. Biomolecules and Biomedicine. 2021;21:501.
5. 5. Köse N, Yıldırım T, Akın F, Yıldırım SE, Altun İ. Prognostic role of NLR, PLR, and LMR in patients with pulmonary embolism. Bosn J Basic Med Sci. 2020;20:248-253.
6. 6. Yildiz G, Selvi F, Bedel C, Zortuk Ö. Systemic inflammation response index and systemic immune-inflammation index for predicting complications of acute appendicitis: A retrospective study. J Acute Dis. 2023;12:23-28.
7. 7. Dziedzic EA, Gąsior JS, Tuzimek A, et al. Investigation of the associations of novel inflammatory biomarkers—Systemic Inflammatory Index (SII) and Systemic Inflammatory Response Index (SIRI)—With the severity of coronary artery disease and acute coronary syndrome occurrence. Int J Mol Sci. 2022;23:9553.
8. 8. Wang RH, Wen WX, Jiang ZP, et al. The clinical value of neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), platelet-to-lymphocyte ratio (PLR) and systemic inflammation response index (SIRI) for predicting the occurrence and severity of pneumonia in patients with intracerebral hemorrhage. Front Immunol. 2023;14:570.

9. 9. Efros O, Beit Halevi T, Meisel E, et al. The prognostic role of neutrophil-to-lymphocyte ratio in patients hospitalized with acute pulmonary embolism. J Clin Med. 2021;10:4058.
10. 10. Boyuk F. The predictor potential role of the glucose to potassium ratio in the diagnostic differentiation of massive and non-massive pulmonary embolism. Clin Appl Thromb Hemost. 2022;28:10760296221076146.
11. 11. Patel P, Patel P, Bhatt M, et al. Systematic review and meta-analysis of test accuracy for the diagnosis of suspected pulmonary embolism. Blood Adv. 2020;4:4296-311.
12. 12. Ordieres-Ortega L, Demelo-Rodríguez P, Galeano-Valle F, et al. Predictive value of D-dimer testing for the diagnosis of venous thrombosis in unusual locations: a systematic review. Thromb Res. 2020;189:5-12.
13. 13. Ertan K, Kara B, Disci SI, Vatansev H, Koksal Y. The Importance of Systemic Inflammatory Response Index, Systemic Immune-Inflammation Index, and Hemoglobin-Albumin-Lymphocytes-Platelets (HALP) Score in Children with Cancer. Iran J Pediatr. 2021;31(6): :e118121.
14. 14. Luo Y, Zhang J, Liu T, Yin Z, Jin Y, Han J, Guo Z, Wang H. The systemic-immune-inflammation index predicts the recurrence of atrial fibrillation after cryomaze concomitant with mitral valve surgery. BMC Cardiovasc Disord. 2022;22:1-6.
15. 15. Öcal L, Keskin M, Cerşit S, et al. Systemic immune-inflammation index predicts in-hospital and long-term outcomes in patients with ST-segment elevation myocardial infarction. Coron Artery Dis. 2022;33:251-60.
16. 16. Kudlinski B, Zgoła D, Stolińska M, et al. Systemic inflammatory predictors of in-hospital mortality in COVID-19 patients: a retrospective study. Diagnostics. 2022;12:859.
17. 17. Chen JH, Zhai ET, Yuan YJ, et al. Systemic immune-inflammation index for predicting prognosis of colorectal cancer. World J Gastroenterol. 2017;23:6261-6272.
18. 18. Chao B, Ju X, Zhang L, Xu X, Zhao Y. A novel prognostic marker systemic inflammation response index (SIRI) for operable cervical cancer patients. Front Oncol. 2020;10:766.
19. 19. Cakcak İE, Kula O. Predictive evaluation of SIRI, SII, PNI, and GPS in cholecystostomy application in patients with acute cholecystitis. Ulus Travma Acil Cerrahi Derg. 2022;28:940-946.