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    Performance of the systemic immune-inflammation index in predicting survival to discharge in out-of-hospital cardiac arrest
    (Elsevier B.V., 2023) Taha Sert, Ekrem; Kokulu, Kamil; Mutlu, Hüseyin; Gül, Murat; Uslu, Yakup
    To investigate whether the systemic immune-inflammatory index (SII) could be used as a prognostic marker of out-of-hospital cardiac arrest (OHCA). Methods: We evaluated patients aged 18 years and older, who presented to the emergency department (ED) due to OHCA between January 2019 and December 2021 and achieved the return of spontaneous circulation after successful resuscitation. Routine laboratory tests were obtained from the first blood samples measured following the patients’ admission to ED. The neutrophil–lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were calculated by dividing the neutrophil and platelet counts by the lymphocyte count. SII was calculated as platelets × neutrophils / lymphocytes. Results: Among the 237 patients with OHCA included in the study, the in-hospital mortality rate was 82.7%. The SII, NLR, and PLR values were statistically significantly lower in the surviving group than in the deceased group. The multivariate logistic regression analysis revealed that SII [odds ratio (OR): 0.68, 95% confidence interval (CI): 0.56–0.84, p = 0.004] was an independent predictor of survival to discharge. In the receiver operating characteristic analysis, the power of SII to predict survival to discharge [area under the curve (AUC): 0.798] was higher than either NLR (AUC: 0.739) or PLR (AUC: 0.632) alone. SII values below 700.8% predicted survival to discharge with 80.6% sensitivity and 70.7% specificity. Conclusion: Our findings showed that SII was more valuable than NLR and PLR in predicting survival to discharge and could be used as a predictive marker for this purpose.
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    Systemic immune inflammation index may be a new powerful marker for the accurate early prediction of complications in patients with acute appendicitis
    (Çukurova Üniversitesi, 2023) Mutlu, Hüseyin; Sert, Ekrem Taha; Kokulu, Kamil; Uslu, Yakup
    To investigate the relationship between the systemic immune-inflammatory index (SII) and acute appendicitis (AA). Materials and Methods: We retrospectively evaluated patients aged over 18 years who were diagnosed with AA and underwent surgery at our clinic from January 1, 2019, through July 31, 2022. The patients were divided into three groups: complicated acute appendicitis (CAA), uncomplicated acute appendicitis (UAA), and control. The clinical and laboratory characteristics of the patients evaluated at the emergency department were recorded. The neutrophil/lymphocyte ratio (NLR), the platelet/lymphocyte ratio (PLR), and SII (neutrophil count x platelet count/lymphocyte count) were calculated.Results: The study included a total of 1,456 patients, of whom 628 had UAA, 104 had CAA, and 714 were controls. The NLR, PLR, and SII values were statistically significantly higher in the CAA group than in the control group and the UAA group. The multivariate logistic regression analysis revealed that SII was an independent predictor of CAA development (odds ratio [OR]: 4.65; 95% confidence interval [CI]: 2.31-10.17). The predictive power of SII in the prediction of CAA (area under the curve [AUC]: 0.809) was much higher than that of NLR (AUC: 0.729), neutrophil count (AUC: 0.696), and C -reactive protein (AUC: 0.732) alone. It was determined that an SII value greater than 1,989.2 had a sensitivity of 78.4% and a specificity of 88.5% in predicting CAA development.Conclusion: SII is a simple, inexpensive, and promising marker that could predict both the diagnosis and severity of appendicitis.