Systemic inflammation response index and systemic immune-inflammation index are associated with severity of acute pancreatitis

Gunay Yildiz 1, Fatih Selvi 1, Cihan Bedel 1 * , Okkes Zortuk 1, Umut Ogün Mutlucan 2
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1 Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
2 Department of Neurosurgery, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
* Corresponding Author
J CLIN MED KAZ, Volume 20, Issue 3, pp. 44-48. https://doi.org/10.23950/jcmk/13320
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ABSTRACT

Aim: Acute pancreatitis (AP) is a disease with inflammation, and patients present with severe acute upper abdominal pain in emergency departments. AP can result in higher mortality as its clinical severity increases. Therefore, in this study, we want to investigate the clinical utility of the systemic inflammation response index (SIRI) and systemic immune-inflammation index (SII) in showing the severity of AP.
Material and methods: Among the patients admitted to our emergency department between January 2020 and December 2022, 201 patients diagnosed with AP were included in the study. These patients were divided into two groups according to the severity of the disease as mild and severe AP (MAP and SAP). Demographic data and laboratory data of the patients (white blood cell count, such as SIRI, SII and C-reactive protein, SIRI, SII and C-reactive protein) were recorded. Differences between groups of AP patients divided according to disease severity were analyzed.
Results: 165 (82.1%) patients had MAP and 36 (17.9%) patients had SAP. 52.8% of the patients were male. The mean of the SAP group was significantly higher than the SII MAP group (3165.71±3058.42 vs.1043.31±849.15; p<0.001). In addition, SII levels were significantly higher in the SAP group compared to MAP (11.19±6.27 vs. 3.12±3.01; p<0.001). In regression analysis, CRP, SIRI and SII was found to be able to predict SAP in patients with AP.  The power of SIRI and SII were found to be higher in predicting SAP [AUC for SIRI: 0.890; [AUC for SII: 0.859].
Conclusion: High SII and SIRI are useful markers that can show the severity of AP.
Key words: acute pancreatitis severity, SII, SIRI, biomarker
Keywords: acute pancreatitis severity, SII, SIRI, biomarker

CITATION

Yildiz G, Selvi F, Bedel C, Zortuk O, Mutlucan UO. Systemic inflammation response index and systemic immune-inflammation index are associated with severity of acute pancreatitis. J CLIN MED KAZ. 2023;20(3):44-8. https://doi.org/10.23950/jcmk/13320

REFERENCES

  • Huang DN, Zhong HJ, Cai YL, Xie WR, He XX. Serum Lactate Dehydrogenase Is a Sensitive Predictor of Systemic Complications of Acute Pancreatitis. Gastroenterol Res Pract. 2022;2022:1131235. https://doi.org/10.1155/2022/1131235
  • Bedel C, Korkut M, Selvi F. New markers in predicting the severity of acute pancreatitis in the emergency department: Immature granulocyte count and percentage. J Postgrad Med. 2021;67:7-11. https://doi.org/10.4103/jpgm.JPGM_784_20
  • Leppäniemi A, Tolonen M, Tarasconi A, Segovia-Lohse H, Gamberini E, Kirkpatrick AW, Ball CG, Parry N, Sartelli M, Wolbrink D, van Goor H. 2019 WSES guidelines for the management of severe acute pancreatitis. World J Emerg Surg. 2019;14:1-20. https://doi.org/10.1186/s13017-019-0247-0
  • Liu X, Guan G, Cui X, Liu Y, Liu Y, Luo F. Systemic Immune-Inflammation Index (SII) Can Be an Early Indicator for Predicting the Severity of Acute Pancreatitis: A Retrospective Study. Int J Gen Med. 2021;14:9483-9489. https://doi.org/10.2147/IJGM.S343110
  • Yi KQ, Yang T, Yang YM, et al. Appraisal of the diagnostic procedures of acute pancreatitis in the guidelines. Syst Rev. 2021;10(1):17. https://doi.org/10.1186/s13643-020-01559-4
  • Ong Y, Shelat VG. Ranson score to stratify severity in Acute Pancreatitis remains valid - Old is gold. Expert Rev Gastroenterol Hepatol. 2021;15:865-877. https://doi.org/10.1080/17474124.2021.1924058
  • Dancu GM, Popescu A, Sirli R, Danila M, Bende F, Tarta C, Sporea I. The BISAP score, NLR, CRP, or BUN: Which marker best predicts the outcome of acute pancreatitis? Medicine (Baltimore). 2021;100:e28121. https://doi.org/10.1097/MD.0000000000028121
  • Jeon TJ, Park JY. Clinical significance of the neutrophil-lymphocyte ratio as an early predictive marker for adverse outcomes in patients with acute pancreatitis. World J Gastroenterol. 2017;23:3883-9. https://doi.org/10.3748/wjg.v23.i21.3883
  • Gu L, Li H, Gao Y, Ma X, Chen L, Li X, et al. The association of platelet count with clinicopathological significance and prognosis in renal cell carcinoma: A systematic review and meta-analysis. PLoS One. 2015;10:e0125538. https://doi.org/10.1371/journal.pone.0125538
  • Roxburgh CS, McMillan DC. Role of systemic inflammatory response in predicting survival in patients with primary operable cancer. Future Oncol. 2010;6:149-63. https://doi.org/10.2217/fon.09.136
  • Lolli C, Basso U, Derosa L, Scarpi E, Sava T, Santoni M, et al. Systemic immune-inflammation index predicts the clinical outcome in patients with metastatic renal cell cancer treated with sunitinib. Oncotarget. 2016;7:54564-71. https://doi.org/10.18632/oncotarget.10515
  • Mederos MA, Reber HA, Girgis MD. Acute Pancreatitis: A Review. JAMA. 2021;325(4):382-390. https://doi.org/10.1001/jama.2020.20317
  • Masamune A, Hamada S, Kikuta K. Implementation of pancreatitis bundles is associated with reduced mortality in patients with severe acute pancreatitis in Japan. Pancreas. 2021;50:e24-5. https://doi.org/10.1097/MPA.0000000000001750
  • Lee DW, Cho CM. Predicting severity of acute pancreatitis. Medicina. 2022;58:787. https://doi.org/10.3390/medicina58060787
  • Eachempati SR, Hydo LJ, Barie PS. Severity scoring for prognostication in patients with severe acute pancreatitis: comparative analysis of the Ranson score and the APACHE III score. Archives of Surgery. 2002;137:730-6. https://doi.org/10.1001/archsurg.137.6.730
  • Kuo DC, Rider AC, Estrada P, Kim D, Pillow MT. Acute pancreatitis: what's the score?. The Journal of emergency medicine. 2015;48:762-70. https://doi.org/10.1016/j.jemermed.2015.02.018
  • Vannier E, Dupont-Lucas C, Lagarde B, Menahem B, Chaigneau T, Piquet MA, Dupont B. Development of a score for predicting severe acute pancreatitis at admission. Pancreas. 2022;51:128-34. https://doi.org/10.1097/MPA.0000000000001984
  • Abu-Elfatth A, Mekky MA, Othman AM, Mohammed SM, El-Mokhtar MA. Neutrophil-Lymphocyte Ratio and Platelet to Lymphocyte Ratio in Prediction of Severe Acute Pancreatitis: A Prospective Single Center Study. The Egypt J Hosp Med. 2022;89:5452-7. https://doi.org/10.21608/ejhm.2022.264525
  • Chao B, Ju X, Zhang L, Xu X, Zhao Y. A novel prognostic marker systemic inflammation response index (SIRI) for operable cervical cancer patients. Frontiers in oncology. 2020;10:766. https://doi.org/10.3389/fonc.2020.00766
  • Dziedzic EA, Gąsior JS, Tuzimek A, Paleczny J, Junka A, Dąbrowski M, Jankowski P. Investigation of the associations of novel inflammatory biomarkers-Systemic Inflammatory Index (SII) and Systemic Inflammatory Response Index (SIRI)-With the severity of coronary artery disease and acute coronary syndrome occurrence. Int J Mol Sci. 2022;23:9553. https://doi.org/10.3390/ijms23179553
  • Li J, Li Y, Zou Y, Chen Y, He L, Wang Y, Zhou J, Xiao F, Niu H, Lu L. Use of the systemic inflammation response index (SIRI) as a novel prognostic marker for patients on peritoneal dialysis. Renal Failure. 2022;44:1227-35. https://doi.org/10.1080/0886022X.2022.2100262
  • Zhang Y, Xing Z, Zhou K, Jiang S. The predictive role of systemic inflammation response index (Siri) in the prognosis of stroke patients. Clin Interv Aging. 2021;16:1997. https://doi.org/10.2147/CIA.S339221
  • Jin Z, Hao D, Song Y, Zhuang L, Wang Q, Yu X. Systemic inflammatory response index as an independent risk factor for ischemic stroke in patients with rheumatoid arthritis: a retrospective study based on propensity score matching. Clin Rheumatol. 2021;40:3919-27. https://doi.org/10.1007/s10067-021-05762-z
  • Li S, Liu K, Gao Y, Zhao L, Zhang R, Fang H, Tao Y, Liu H, Zhao J, Xia Z, Xu Y. Prognostic value of systemic immune-inflammation index in acute/subacute patients with cerebral venous sinus thrombosis. Stroke Vasc Neurol. 2020;5: e000362. https://doi.org/10.1136/svn-2020-000362
  • Trifan G, Testai FD. Systemic immuneinflammation (SII) index predicts poor outcome after spontaneous supratentorial intracerebral hemorrhage. J Stroke Cerebrovasc Dis. 2020;29: 105057. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105057
  • Hu B, Yang XR, Xu Y, Sun YF, Sun C, Guo W, Zhang X, Wang WM, Qiu SJ, Zhou J. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res. 2014;20:6212-6222. https://doi.org/10.1158/1078-0432.CCR-14-0442
  • Topcuoglu MA, Pektezel MY, Yilmaz E, Arsava EM. Systemic inflammation indices in patients with acute ischemic stroke treated with intravenous tissue plasminogen activator: clinical yield and utility. Angiology. 2021;72:279-284. https://doi.org/10.1177/0003319720969997
  • Silva-Vaz P, Abrantes AM, Morgado-Nunes S, Castelo-Branco M, Gouveia A, Botelho MF, et al. Evaluation of prognostic factors of severity in acute biliary pancreatitis. International journal of molecular sciences. 2020;21(12):4300. https://doi.org/10.3390/ijms21124300
  • Silva-Vaz P, Jarak I, Rato L, Oliveira PF, Morgado-Nunes S, Paulino A, et al. Plasmatic oxidative and metabonomic profile of patients with different degrees of biliary acute pancreatitis severity. Antioxidants. 2021;10(6):988. https://doi.org/10.3390/antiox10060988