Evaluation of the efficiency of the systemic immune‐inflammation index in differentiating parapneumonic effusion from empyema

Abstract

Aim: To evaluate the effectiveness of the systemic immune-inflammation index (SII) and other biomarkers in distinguishing parapneumonic effusion (PPE) and empyema.Methods: Patients who were thought to have pleural effusion secondary to pneumonia in the pediatric emergency department (PED) between 2004 and 2021 were retrospectively evaluated. The patients were divided into two groups as empyema and PPE. The efficacy of infection markers in predicting empyema was compared.Results: Fifty-nine patients (59.3% male) were included in the study. Forty-three (72.9%) patients were in the PPE and 16 (27.1%) were in the empyema group.Length of hospital stay and pleural fluid thickness measured with thoracic ultrasonography were significantly higher in the empyema group (p = 0.018 and p = 0.002, respectively). The mean SII was 1902.73 ± 1588.87 in PPE patients, while it was 6899.98 ± 6678 in empyema patients (p = 0.009). C-reactive protein (CRP), white blood cell (WBC) count, absolute neutrophil count (ANC), and neutrophillymphocyte ratio (NLR) were significantly higher in the empyema group; absolute lymphocyte count (ALC) and lymphocyte-monocytes ratio (LMR) were significantly lower than the PPE group. When the best cut-off values of inflammation markers are determined according to the area under the curve, the highest odds ratios suggesting empyema were found in SII, LMR, CRP, and ANC, respectively. Conclusion:Inflammation markers can be useful in predicting empyema. The best markers were found to be SII, LMR, CRP, and ANC. High SII is one of the practical diagnostic markers that can be used differentiate empyema from PPE in PED.

The effect of the pretreatment systemic immune-inflammatory index and C-reactive protein-to-albumin ratio on prognosis in pediatric patients with IgA vasculitis

“…Previous studies have shown that the NLR value is higher in patients with renal and systemic involvement in IgAV than in patients without renal and systemic involvement (3,22,44,46). In recent years, SII, which uses neutrophils, platelets, and lymphocytes together, and the CAR index, which evaluates CRP and albumin together, have attracted the attention of researchers and been used to evaluate disease pathogenesis and severity of inflammation in many diseases (15,19,21,(27)(28)(29)(47)(48)(49)(50). Since CAR provides the opportunity to evaluate increased CRP and decreased serum albumin together in chronic inflammation, it has provided researchers with a twoway perspective.…”

Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune inflammation index (SII) to predict postoperative pneumonia in elderly hip fracture patients

“…Moreover, chest X-ray examinations, an essential component in the diagnostic procedure, may not effectively identify infiltrations during preliminary stages of infection, instead functioning as a secondary measure in later stages [ 46 , 47 ]. Regrettably, treatment delays could hinder patient recovery and exacerbate functional prognosis, highlighting the need for additional biomarkers with accurate predictive abilities for POP [ 28 , 31 ]. In this study, the occurrence of POP in hip fracture patients was 9.26%, aligning with previous literature [ 14 , 38 , 48 , 49 ].…”

“…Among all tested inflammatory/immunological markers, NLR emerged as the most robust predictor for this condition. Consequently, it is recommended to calculate NLR and SII values, especially NLR, upon admission of elderly hip fracture patients to identify individuals who may benefit from intensified respiratory support and intervention targeting respiratory infections, thereby ensuring a favorable prognosis [ 26 , 31 , 48 ].…”

“…Furthermore, alterations in certain inflammatory/immune markers (NLR and PLR) have been observed after long bone fractures [ 30 ]. The SII is a novel marker that combines peripheral blood lymphocyte, neutrophil, and platelet counts and is linked to inflammation [ 31 ]. Previous studies have highlighted SII's high prognostic value in cancer patients, as well as its significance in predicting POP in lung cancer patients [ 32 , 33 ].…”

Study of clinical traits and systemic immune inflammation index assessments in patients with endogenous endophthalmitis over the last ten years

“…The Systemic Immune Inflammation Index (SII) is a new predictive scale for immune inflammation based on neutrophil, lymphocyte, and platelet counts. It is a prognostic indicator and an independent predictor of a variety of diseases, such as cancer, coronary artery disease, autoimmune disease, and infectious disease [3][4][5][6]. The SII has been linked to primary open-angle glaucoma, keratoconus, and dry eye disease in the field of ophthalmology [7][8][9].…”