The association between systemic inflammatory response index and in‐hospital mortality in patients with infective endocarditis

Abstract

Background Infective endocarditis (IE) has a significant mortality, and early identification of high‐risk patients and prediction of poor outcomes is of great significance. In recent years, increasing research has revealed the predictors associated with infective endocarditis prognosis. Systemic inflammatory response index (SIRI) is an important new indicator of inflammation. So far, there have been no reports on the relationship between SIRI and the prognosis of IE patients. Hypothesis The purpose of this study was to explore the value of SIRI in predicting in‐hospital death for patients with infective endocarditis (IE), so as to provide reference for improving the prognosis of patients with IE. Method A retrospective analysis was performed on the clinical data of patients with IE admitted to the First Affiliated Hospital of Nanjing Medical University from January 2017 to December 2019. SIRI was calculated according to the blood routine results of patients at admission; receiver operating characteristic curve was employed to determined the optimal cutoff value of SIRI. Patients were divided into groups (low SIRI group and high SIRI group; nonsurvivor group and survivor group) according to the levels of SIRI or their prognosis, and the general clinical features of the two groups were compared. Univariate and multivariate logistic regression analysis were performed to analyze the independent prognostic factors of in‐hospital death in IE patients. Results A total of 147 IE patients meeting the diagnostic criteria were included, including 102 males (69.4%) and 45 females (30.6%). There was statistically significant difference in SIRI level between nonsurvivor group and survivor group (p < .05). After adjusting for the related factors, the risk of in‐hospital death in the high SIRI was still a risk of in‐hospital death with statistical significance (hazard ratio = 5.053, 95% confidence interval: 1.426‒17.905, p = .012). Conclusions Higher SIRI level is independently associated with the risk of in‐hospital death in IE patients, and can be an independent predictor of poor outcome in IE patients.

The Prognostic Value of Hematologic Inflammatory Markers in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

“… 4 In addition, SIRI was shown to be associated with C-reactive protein (CRP) levels, suggesting that SIRI is an indicator of inflammation levels in the body. 31 , 34 It has also been verified that SIRI was relatively more stable than CRP, as the latter parameter had a greater risk of being impacted by blood specimen handling techniques and other infectious diseases. 35 Our study also found that patients with higher SIRI levels had a greater risk of long-term clinical cardiovascular outcomes.…”

“… 30 These composite indicators are more stable and less susceptible than a single inflammatory indicator. 31 Previous studies have shown that SIRI is a predictor of prognosis in various types of cancer. 32 Very few studies have evaluated its association with patients with ACS after PCI.…”

“…They found that in infective endocarditis patients, SIRI was an independent predictor of poor outcome and a higher SIRI level was independently associated with the risk of in-hospital death. 31 Jin et al (2021) found that a high risk of myocardial infarction was independently associated with high SIRI. 33 Recently, Li et al (2022) conducted a prospective observational study in the cardiovascular center of Beijing Anzhen Hospital and found that SIRI ≥1.13 was significantly and independently associated with MACE in ACS patients who underwent PCI (HR: 2.561; 95%CI: 1.681-3.902; P < .001).…”

“…A high SIRI status reflects a strong pro-inflammatory response mediated by monocytes and neutrophils and weak or inhibited lymphocyte-mediated anti-inflammatory response. 8 , 31 Consequently, an elevated SIRI is linked to aggravated inflammation and poor ACS outcomes.…”

Evaluation of prognostic inflammatory and systemic inflammatory response indices in auxiliary diagnosis of bacteria-negative pulmonary tuberculosis: A diagnostic accuracy study

“…[3] Studies have shown that prognostic inflammatory index (PII) and systemic inflammatory response index (SIRI) are new indicators for evaluating systemic inflammation, nutrition, and immune status; which have been used in the diagnosis and prognosis of cancer and infectious diseases, such as breast cancer, gastric cancer, rectal cancer, and infective endocarditis. [6][7][8][9] PII and SIRI are calculated according to the laboratory indicators of patients during hospitalization, which has the added advantages of simplicity and convenience. [6,10] Pathological changes in pulmonary TB mainly include inflammatory exudation, hyperplasia, and caseous necrosis.…”