Association between systemic immune-inflammation index and risk of lower extremity deep venous thrombosis in hospitalized patients: a 10-year retrospective analysis

Abstract

BackgroundThe systemic immune-inflammation index (SII), as a novel inflammatory biomarker, has recently attracted attention in cardiovascular disease research. However, the relationship between SII and risk of lower extremity deep venous thrombosis (LEDVT) remains unclear to date. Thus, this study aimed to explore the association in a large sample over a 10-year period (2012–2022).MethodsAll hospitalized patients undergoing lower extremity compression ultrasonography (CUS) examination were consecutively screened by searching our hospital information system database. The receiver operating characteristic (ROC) curve analysis was used to identify the optimal cut-off value for high and low SII group. Multivariate logistic regression analyses were performed to investigate the relationship between SII and LEDVT risk. Propensity score matching (PSM), subgroup and sensitivity analyses were also conducted. Moreover, restricted cubic spline (RCS) regression and two-piecewise linear regression models were used to assess the dose-response relationship between natural log transformed SII [ln(SII)] and risk of LEDVT.ResultsA total of 16,725 consecutive hospitalized patients were included, and 1,962 LEDVT events occurred. After adjusting for confounding factors, patients in the high SII group (≥ 574.2 × 109/L) showed a 1.740-fold risk of LEDVT (95% CI: 1.546–1.959, P < 0.001), and elevated ln(SII) was associated with a 36.1% increased risk of LEDVT (95% CI: 1.278–1.449, P < 0.001). PSM, subgroup and sensitivity analyses confirmed the robustness of the association. A non-linear relationship was observed (Pnon−linear < 0.001), with a threshold value of 5.6 × 109/L for all LEDVT events. Above the threshold, each unit increase in ln(SII) had a 1.369-fold higher risk of LEDVT (95% CI: 1.271–1.475, P < 0.001). The association also existed in both distal and proximal LEDVT.ConclusionElevated SII is significantly associated with an increased risk of LEDVT in hospitalized patients. Additionally, the association is non-linear and exhibit a threshold effect.

High systemic inflammation response index level is associated with an increased risk of lower extremity deep venous thrombosis: a large retrospective study

“…For instance, patients in the highest quartile of SIRI had a 2.101-fold and 4.734-fold increased risk of distal and proximal LEDVT, respectively, compared with those in the lowest quartile. To the best of our knowledge, except for our previous study [ 28 ], no prior study has investigated the association between any inflammation biomarker and distal or proximal LEDVT risk. In addition, sensitivity and subgroup analyses yielded similar findings, suggesting that the association was robust and reliable.…”

“…The requirement for patient informed consent was waived because of the retrospective and anonymous nature of the study. The study population has been described in our previous study [ 28 ]. Briefly, all medical and surgical hospitalized patients undergoing lower extremity compression ultrasonography (CUS) examinations, between 1 January 2012 and 31 July 2022, were consecutively identified from our hospital information system (HIS) database.…”

“…To date, growing evidence supports the involvement of inflammation in DVT initiation and resolution [ 23–25 ]. Moreover, several inflammatory biomarkers have been found to be associated with DVT, including the neutrophil-to-lymphocyte ratio (NLR) [ 26 ], monocyte-to-lymphocyte ratio (MLR) [ 27 ], and systemic inflammatory index (SII) [ 28 ]. These studies have shown promising results; however, none of these biomarkers has reached consensus conclusions with good clinical guidelines [ 29 ].…”