Title:Effect of Novel Inflammatory Biomarkers on Adverse Outcomes in Patients with Interstitial Lung Disease and Pneumonia: A Multicenter
Retrospective Cohort Study
Volume: 28
Issue: 5
Author(s): Wenmei Bai*, Yide Wang and Fengsen Li*
Affiliation:
- The Fourth Clinical College of Xinjiang Medical University, Urumqi, China
- Department of Respiratory and Critical
Care Medicine, Fourth Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- The Fourth Clinical College of Xinjiang Medical University, Urumqi, China
- Department of Respiratory and Critical
Care Medicine, Fourth Affiliated Hospital of Xinjiang Medical University, Urumqi, China
Keywords:
Interstitial lung disease, pneumonia, prognosis, systemic immune inflammatory index, cox regression model analysis, kaplan-meier survival analysis.
Abstract:
Background: Interstitial lung disease frequently coincides with pneumonia in clinical
settings, and both conditions are closely associated with immunoinflammation. The Systemic Immune
Inflammatory Index (SII) is a recently identified marker, and its connection to the prognosis
of individuals suffering from interstitial lung disease and concurrent pneumonia remains unclear.
The objective of this study was to scrutinize the correlation between varying SII levels and unfavorable
outcomes in patients grappling with interstitial lung disease complicated by pneumonia.
Methods: This study encompassed a retrospective multicenter cohort of 324 patients diagnosed
with interstitial lung disease and pneumonia, all receiving glucocorticoid treatment during their
hospitalization. We initially conducted ROC analysis to determine the optimal SII threshold.
Subsequently, we examined disparities in clinical symptoms, physical signs, clinical test data,
and other clinical attributes among patients with differing SII levels. Later, we employed the
Kaplan-Meier survival curve method to assess the association between distinct SII levels and the
30-day and 90-day mortality rates in patients dealing with interstitial lung disease complicated
by pneumonia. Finally, a Cox regression model was employed to identify factors influencing adverse
prognosis in these patients.
Results and Discussion: The findings demonstrated that the optimal SII threshold for predicting
30-day mortality was 1416.97, with an AUC of 0.633 (95% CI: 0.559-0.708) and a P value of
<0.001. For 90-day mortality, the optimal SII threshold was 994.59, yielding an AUC of 0.628
(95% CI: 0.56-0.697) and a P value of <0.001. Noteworthy statistical distinctions emerged in
dyspnea, cyanosis, and oxygenation index among patients with varying SII levels. Additionally,
invasive mechanical ventilation, non-invasive ventilation, and extended infection duration independently
constituted 30-day and 90-day mortality risk factors. Elevated heart rate and higher SII
levels emerged as independent risk factors for 90-day mortality.
Conclusion: To some extent, SII levels exhibit correlations with the clinical manifestations in
patients grappling with interstitial lung disease complicated by pneumonia. Notably, a high SII
level is an independent predictor for an unfavorable prognosis in these patients. Nevertheless,
these findings warrant further validation through prospective cohort studies.
