Systemic Immune-Inflammation Index (SII) Can Be an Early Indicator for Predicting the Severity of Acute Pancreatitis: A Retrospective Study

Abstract

Objective: Systemic immune-inflammation index (SII) is a new systemic inflammatory prognostic indicator associated with outcomes in patients with different tumors. Studies have shown an association between SII and many chronic/acute inflammatory diseases. This study aimed at exploring whether SII can be used as an effective parameter for predicting the severity of acute pancreatitis (AP). Methods: A total of 101 acute pancreatitis patients were enrolled in this study (mild acute pancreatitis (MAP): n = 73 and severe acute pancreatitis (SAP): n = 28). Patient demographics and SII were analyzed using the chi-square test, Student's t-test, and Mann-Whitney U-test. A receiver operating characteristic curve was generated to test the potential of using neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and SII to predict AP's severity. Logistic regression analysis was performed to determine major risk factors. Results: Patients with SII value ≥2207.53 had a higher probability of having SAP (sensitivity = 92.9%, specificity = 87.7%, and AUC = 0.920), and SII was a significantly better predictive value than PLR and NLR. Logistic regression analysis results showed SII could differentiate MAP from SAP as a major risk factor. Conclusion:This study has shown that SII is a potential indicator for predicting the severity of acute pancreatitis. The findings suggested that SII is more sensitive and specific than NLR and PLR in predicting the severity of acute pancreatitis.

Investigation of systemic immune-inflammation index, neutrophil/high-density lipoprotein ratio, lymphocyte/high-density lipoprotein ratio, and monocyte/high-density lipoprotein ratio as indicators of inflammation in patients with schizophrenia and bipolar disorder

“…The SII, which brings together three inflammatory peripheral cell counts including neutrophils, lymphocytes, and platelets, is increasingly considered a readily available biomarker for systemic inflammation ( 20 , 35 , 36 ). It can better reflect the body’s immune and inflammatory states than any aforementioned markers in isolation.…”

“…It can better reflect the body’s immune and inflammatory states than any aforementioned markers in isolation. Previous studies have found that the SII has an important role in predicting the prognosis of patients with some physical diseases, such as tumors, cerebral infarction, cardiovascular disease, and acute pancreatitis ( 18 , 20 , 21 , 36 ). As far as we know, there are few studies on the SII in psychiatric disorders.…”

“…The systemic immune-inflammation index (SII) is a new marker reflecting the immune response and inflammation, defined as the platelet counts × neutrophil-to-lymphocyte ratio ( 18 , 19 ). In some physical health disorders, such as ischemic stroke, cardiovascular disease, and pancreatitis, the SII has been found to be able to predict disease severity and prognosis ( 20 – 22 ). The system inflammation response index (SIRI) is an innovative inflammation-based biomarker, which integrates peripheral counts of neutrophils, monocytes, and lymphocytes ( 23 ); until now, the SIRI has been found to be a prognostic factor for cancers such as cholangiocarcinoma, nasopharyngeal carcinomas, and esophageal, gastric, and pancreatic cancers ( 24 ).…”

Correlation of systemic immune-inflammation Index with surgical necrotizing enterocolitis

“…It has been considered as a better index to reflect the local immune response and systemic inflammation. SII was first described as predictor for the prognosis of hepatocellular carcinoma ( 9 ), but it has been recently applied in inflammation-linked diseases such as acute pancreatitis and COVID-19 ( 12 , 13 ). During systemic inflammation, thrombocytosis and neutrophilia are considered responses to systemic inflammation, and lymphopenia predicts cellular immune injury.…”

“…SII can be used as an effective index to assess the degree of inflammation. For example, SII could effectively identify the severity of acute pancreatitis, outperformed NLR and PLR ( 12 ). Compared with mild COVID-19 patients, the severe had significantly higher SII value ( 13 ).…”