The Predictive Role of Systemic Inflammatory Markers in the Development of Acute Kidney Failure and Mortality in Patients with Abdominal Trauma

Abstract

Background: Abdominal trauma is defined as a variety of injuries to the abdominal wall, solid or hollow intra-abdominal organs, and various intra-abdominal vessels. Recently, there has been a significant amount of interest in the establishment of a reliable biomarker that can predict the outcome in patients with an abdominal injury. The purpose of this study is to confirm the predictive role of inflammatory biomarkers and underlying risk factors and the risk of acute kidney insufficiency (AKI) developing and mortality in abdominal trauma patients; Materials and methods: The current study was intended as an observational, analytical, retrospective cohort study and included all patients over 18 years of age with a diagnosis of abdominal trauma confirmed through a CT scan admitted to the County Emergency Clinical Hospital of Targu-Mureș, Romania between January 2017, and December 2021; Results: Non-survivor patients had a greater age (p = 0.02), as well as a higher prevalence of ischemic heart disease (IHD) (p = 0.007), history of myocardial infarction (MI) (p = 0.002), peripheral arterial disease (PAD) (p = 0.01), chronic kidney disease (CKD) (p = 0.01), and all risk factors (p = 0.0004 and p < 0.0001). In terms of injured organs, we have in the second group a higher incidence of kidney injury (p = 0.003) and hemoperitoneum (p = 0.008). Multivariate analysis showed a high baseline value for all inflammatory biomarkers that are independent predictors of adverse outcomes for all recruited patients. Furthermore, for all hospitalized patients, the history of MI (p = 0.03; p = 0.001; and p = 0.003), PAD (p = 0.01; p = 0.01; and p = 0.002), obesity (for all p < 0.0001), CKD (p < 0.001; p = 0.01; and p = 0.001), and kidney injury (p = 0.02; p = 0.004; and p = 0.01) were independent predictors of all outcomes. Moreover, IHD (p = 0.008 and p = 0.02), tobacco (p < 0.0001 and p = 0.02), and hemoperitoneum (p = 0.009 and p = 0.01) were predictors of mortality and composite endpoint, but not for AKI risk, as well as atrial fibrillation [AF] (p = 0.04) as predictors of the composite endpoint Conclusions: Higher monocyte to lymphocyte ratio (MLR), platelets to lymphocyte ratio (PLR), systemic inflammatory index (SII), neutrophil to lymphocyte ratios (NLR), aggregate inflammatory systemic index (AISI), and systemic inflammatory response index (SIRI) levels at admission, according to our data, highly predict AKI risk and death.

Intimal CD31-Positive Relative Surfaces Are Associated with Systemic Inflammatory Markers and Maturation of Arteriovenous Fistula in Dialysis Patients

“…Regarding the laboratory parameters, we included in this study the laboratory data from samples taken pre-operatively. In terms of systemic inflammatory markers, we measured the IL-6 level and hematological ratios (neutrophil–lymphocyte ratios (NLR), platelet–lymphocyte ratios (PLR), and the systemic inflammatory index (SII)) [ 3 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ]. The patients provided written informed consent for the publication of any data.…”

The role of neutrophil‐to‐lymphocyte ratio, platelet‐to‐lymphocyte ratio, and systemic immune inflammation index in predicting the necessity for surgery and therapeutic surgery in patients with anterior abdominal stab wounds

“…Vulvulea et al 20 . discovered that NLR, PLR, and SII values played a significant predictive role in the development of acute kidney insufficiency (AKI) and mortality risk in patients with abdominal trauma.…”

“…The receiver operating characteristics analysis of the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic immune inflammation index in predicting therapeutic surgery. [Colour figure can be viewed at wileyonlinelibrary.com] Vulvulea et al 20 discovered that NLR, PLR, and SII values played a significant predictive role in the development of acute kidney insufficiency (AKI) and mortality risk in patients with abdominal trauma. Yucel et al 5 found that leukocytes, leukocyte subgroups, NLR and PLR were significantly effective in determining the necessity of laparotomy in 547 patients with ASW who lacked immediate surgical findings.…”

Systemic Inflammatory Response Index (SIRI) is associated with all-cause mortality and cardiovascular mortality in population with chronic kidney disease: evidence from NHANES (2001–2018)

“…SIRI was initially used for the assessment of tumor prognosis (31,32), however, the latest findings suggest that an elevated SIRI strongly correlates with unfavorable outcomes in acute coronary syndrome, cardiovascular event mortality, arrhythmias among stroke patients, and major adverse cardiovascular events following percutaneous coronary intervention (PCI) (33)(34)(35). A limited number of studies suggest that SIRI may offer distinct predictive utility in the prediction of acute kidney injury resulting from abdominal trauma (36). An analysis of SIRI elevation and cardiovascular mortality risk in hypertensive patients revealed that those in the fourth quartile of SIRI had a 2.9-fold increased risk of cardiovascular death compared to patients in the first quartile (37).…”