Pan-immune-inflammation value and platelet indices as mortality markers in intensive care patients with sepsis

Öz

Objective: Sepsis remains a major global health problem with high morbidity and mortality rates, mostly in intensive care unit (ICU) settings. The Pan-Immune Inflammation Value (PIIV), a composite marker derived from neutrophil, monocyte, platelet, and lymphocyte counts, has recently emerged as a potential indicator of systemic inflammation. This study aimed to evaluate the prognostic performance of PIIV and platelet-derived indices, including mean platelet volume (MPV) in predicting 30-day mortality among ICU-admitted sepsis patients. Methods: This retrospective study included 191 adult patients with sepsis admitted to the ICU of a tertiary care hospi-tal. Laboratory parameters, including PIIV, MPV, PLR, and lactate, along with various clinical and laboratory parame-ters were recorded within the first 24 hours of ICU admission. Logistic regression analysis (LRA) and receiver operat-ing characteristic curve (ROC) analysis were performed to determine predictors of 30-day mortality. Results: Of the total cohort, 96 patients (50.3%) died within 30 days after ICU admission. PIIV, MPV, and lactate levels were found to be elevated in non-survivors (p=0.001, p=0.003, and p=0.001, respectively). In multivariate LRA, PIIV (OR: 1.235; 95% CI: 1.086–1.404; p=0.001), MPV (OR: 1.346; 95% CI: 1.111–1.630; p=0.002), lactate, and urea were independently associated with mortality. ROC analysis showed that PIIV had an AUROC of 0.643 at a cut-off value of ≥1.2, while MPV had an AUROC of 0.623 at a cut-off of ≥11.5 fL. Conclusion: Integrating PIIV and MPV into the clinical assessment of sepsis patients may improve decision-making in the management of critically ill septic patients in intensive care units.

Anahtar Kelimeler

• Sepsis
• prognosis
• mortality
• pan-immune-inflammation value
• platelet indices

Yoğun bakım ünitesinde sepsis tanılı hastalarda mortalitenin belirteçleri olarak pan-immün-inflamasyon değeri ve trombosit indeksleri

Öz

Amaç: Sepsis, çoğunlukla yoğun bakım ünitesi (YBÜ) ortamlarında yüksek morbidite ve mortalite oranlarına sahip önemli bir küresel sağlık sorunu olmaya devam etmektedir. Nötrofil, monosit, trombosit ve lenfosit sayımlarından türetilen bir bileşik belirteç olan Pan-İmmün İnflamasyon Değeri (PIIV), son zamanlarda sistemik inflamasyonun potansiyel bir göstergesi olarak ortaya çıkmıştır. Bu çalışma, YBÜ'ye yatırılan sepsis hastalarında 30 günlük mortalit-eyi tahmin etmede PIIV ve ortalama trombosit hacmi (MPV) dahil olmak üzere trombosit kaynaklı endekslerin prog-nostik performansını değerlendirmeyi amaçlamaktadır. Yöntem: Bu retrospektif çalışmaya, üçüncü basamak bir hastanenin YBÜ'süne yatırılan 191 yetişkin sepsis hastası dahil edilmiştir. YBÜ'ye yatışın ilk 24 saati içinde PIIV, MPV, PLR ve laktat gibi laboratuvar parametreleri ile çeşitli klinik ve laboratuvar parametreleri kaydedilmiştir. 30 günlük mortalitenin öngörücülerini belirlemek için lojistik regresyon analizi (LRA) ve alıcı işletim karakteristik eğrisi (ROC) analizi yapıldı. Bulgular: Toplam kohorttan 96 hasta (%50,3) yoğun bakım ünitesine yatışından sonraki 30 gün içinde öldü. PIIV, MPV ve laktat düzeylerinin hayatta kalamayan hastalarda yüksek olduğu bulundu (sırasıyla p=0,001, p=0,003 ve p=0,001). Çok değişkenli LRA'da, PIIV (OR: 1,235; %95 GA: 1,086-1,404; p=0,001), MPV (OR: 1,346; %95 GA: 1,111-1,630; p=0,002), laktat ve üre mortalite ile bağımsız olarak ilişkiliydi. ROC analizi, PIIV'in ≥1,2 kesme değerinde 0,643 AUROC değerine sahip olduğunu, MPV'nin ise ≥11,5 fL kesme değerinde 0,623 AUROC değerine sahip olduğunu göstermiştir. Sonuç: PIIV ve MPV'nin sepsis hastalarının klinik değerlendirmesine entegre edilmesi, yoğun bakım ünitelerinde kritik septik hastaların yönetiminde karar verme sürecini iyileştirebilir.

Anahtar Kelimeler

• Sepsis
• prognoz
• mortalite
• pan-immün inflamasyon değeri
• trombosit indeksleri

Kaynakça

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