Systemic Immune-Inflammation and Systemic Inflammation Response Indices are Predictive Markers of Mortality in Inpatients Internal Medicine Services

Abstract

Betül Çavuşoğlu Türker,1 Süleyman Ahbab,1 Fatih Türker,1 Emre Hoca,1 Ece Çiftçi Öztürk,1 Atay Can Kula,2 Hüseyin Öztürk,3 Ayşe Öznur Urvasızoğlu,1 Merve Bulut,4 Özge Yasun,5 Hayriye Esra Ataoğlu1 1Department of Internal Medicine, University of Health Sciences, Haseki Health Training and Research Hospital, İstanbul, Turkey; 2Internal Medicine Department, Ivrindi State Hospital, Balıkesir, Turkey; 3Department of Internal Medicine, University of Health Sciences, Başakşehir Çam ve Sakura City Hospital, İstanbul, Turkey; 4Department of Internal Medicine, University of Health Sciences, Gaziosmanpaşa Taksim Health Training and Research Hospital, İstanbul, Turkey; 5Internal Medicine Department, Hakkari State Hospital, Hakkari, TurkeyCorrespondence: Fatih Türker, University of Health Sciences, Haseki Health Training and Research Hospital, Internal Medicine Clinic, Aksaray, Dr. Adnan Adıvar Cd. No: 9, İstanbul, 34130, Turkey, Tel [phone], Fax [phone], Email [email protected]: Internal medicine services serve the patient population with many chronic diseases. Therefore, it is high mortality rates compared to other departments of the hospital. Estimating the prognostic risk of hospitalized patients may be useful in mortality for patients. İn this study, we evaluated the level of Systemic Immune Inflammation Index (SII) and Systemic Inflammation Response Index (SIRI) and its association with mortality in inpatients.Patients and methods: This study was performed in 2218 patients who were hospitalized between January 1st–December 31th of 2019. Patients were followed up for three years about primary endpoint as all-cause (except for unnatural deaths) mortality. Participants were divided into 4 equal groups according to their increasing levels of SII and SIRI. (Quartile 1– 4) Age, gender, diabetes mellitus, hypertension, coronary artery disease, chronic kidney disease, malignancies (solid), white blood cell, neutrophil, lymphocyte, monocytes, hemoglobin, hematocrit, platelet, CRP, albumin, Systemic Inflammation Response Index (Quartile 1– 4), Systemic Immune Inflammation Index (Quartile 1– 4) were compared between survival and non-survival groups.Results: There were 1153 female and 1065 male participants enrolled. Compared with surviving patients, patients who died were older and had a higher prevalence of diabetes mellitus, hypertension, malignancy, chronic kidney disease and coronary artery disease (p < 0.001). There was a lower proportion of female patients among the patients who died. Compared to the survivor group, group who died exhibited a significant increase in CRP level, neutrophil, white blood cell and monocyte counts, but had a lower lymphocyte count, albumin level and hemoglobin count (P < 0.001). Results of Cox regression analysis showed that age, chronic kidney disease, malignancy, SIRI quartile 3, 4 and SII quartile 3, 4 pointed out a close relationship with mortality risk. (P < 0.001).Conclusion: The SIRI and SII have indicated the clinical importance of as novel markers for predicting mortality in inpatients.Keywords: internal medicine inpatients, mortality, SIRI, SII

Keywords

• i̇nternal medicine inpatients
• mortality
• siri
• sii