Systemic Immune-Inflammation Index Predicted Short-Term Outcomes in Patients Undergoing Isolated Tricuspid Valve Surgery

Abstract

Systemic immune-inflammation index (SII, platelet × neutrophil/lymphocyte ratio) has recently been identified as an inflammatory marker. We aimed to evaluate the prognostic implications of preoperative SII in patients undergoing isolated tricuspid valve (TV) surgery. In total, 213 patients who underwent isolated TV surgery between January 2000 and December 2018 were enrolled. They were divided into two groups, as follows: low SII (<455.6 × 109/L), and high SII (≥455.6 × 109/L). The correlation between SII and clinical outcomes was analyzed via the Cox regression and the Kaplan–Meier analyses. The primary outcomes considered were all-cause mortality and major postoperative complications within a 30-day period after isolated TV surgery, including major adverse cardiovascular or cerebrovascular events, pulmonary and renal complications, stroke, sepsis, multi-organ failure, wound, and gastrointestinal complications. In total, 82 (38.5%) patients experienced postoperative complications. Multivariable analyses revealed that high preoperative SII values were independently associated with the major 30-day postoperative complications (hazard ratio 3.58, 95% confidence interval 1.62–7.95, p = 0.001). Additionally, Kaplan–Meier analysis revealed that the probability of undergoing major 30-day postoperative complications was significantly elevated in patients with high versus low SII values (p < 0.001). These results indicate that SII, a readily available parameter, is significantly associated with poor outcomes in patients undergoing isolated TV surgery.

Systemic-Immune-Inflammation Index as a Promising Biomarker for Predicting Perioperative Ischemic Stroke in Older Patients Who Underwent Non-cardiac Surgery

“…Additionally, the association of elevated SII (> 694.3 × 10 9 ) with postoperative major adverse cardiovascular events was elucidated in individuals with coronary heart disease ( Yang et al, 2020 ). An increased SII (≥ 455.6 × 10 9 ) also showed significant prognostic value for predicting all-cause mortality and major postoperative complications in patients undergoing isolated tricuspid valve surgery ( Yoon et al, 2021 ).…”

Systemic immune‐inflammation index predicted short‐term outcomes in ATAD patients undergoing surgery

“…Firstly, the cut-off value for the high SII was simply calculated through ROC curve, in accordance with previous study. 4 The value in ATAD patients was higher than that in patients with chronic cardiovascular diseases. 12 In addition, the average age of patients enrolled in the study seemed to be younger, which may cause bias.…”

“…And SII was calculated based on formula described as: SII = neutrophil count × platelet count/lymphocyte count. 4 And major adverse cardiovascular events include myocardial infarction, malignant ventricular arrhythmia, hospitalization because of heart failure, and application of mechanical assist device. 4 The short-term outcomes are defined as survival rate, postoperative complications and length of stay in intensive care unit (ICU) and hospital within 30 days in our study.…”

“…And recently, high SII was demonstrated as a valuable tool to predict the poor outcomes of patients undergoing tricuspid valve surgery. 4 However, the association between systemic inflammation and prognosis of ATAD patients undergoing surgery has not been illustrated yet.…”

The malnutritional facet of inflammatory prognostication in acute aortic dissection

“…evaluating the prognostic potential of SII in tricuspid valve surgery interestingly revealed lower serum albumin levels in patients with a preoperative SII ≥ 455.6 × 10 9 /L in contrast to those with SII < 455.6 × 10 9 /L (3.6 ± 0.7 vs. 3.8 ± 0.5 g/dl, p = 0.031). 5 Moreover, ahead of the novel-to-conventional biomarkers like SII and albumin, the importance of a composite immunonutritional assessment is nested in the findings of Keskin et al and Lin et al studies deciphering an independent in-hospital mortality predictive value of the prognostic-nutritional index (computed from the preoperative albumin-lymphocyte levels) in 151 and 651 surgical type-A AAD patients, respectively. 3,4 While the inclusion of albumin in the Xu et al analysis could have potentially added an enhanced lucidity, the larger point remains that the malnutritional facet of inflammatory prognostication in peculiar subsets like AAD can certainly not be overlooked in the present era propounding the need for a holistic preoperative immunonutritional evaluation.…”