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Systemic Immune-Inflammation Index Is Associated with Adverse Outcomes in Patients Hospitalized for AECOPD: A Multicenter Cohort Study

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收录情况： ◇ SCIE

作者：
Chen Xueqing[1] * ; Liu Shiman[2] * ; Luo Yuanming[3] ; Wei Hailong[4] ; Ge Huiqing[5] ; Liu Huiguo[6] ; Zhang Jianchu[7] ; Li Xianhua[8] ; Pan Pinhua[9] ; Xie Xiufang[8] ; Yi Mengqiu[10] ; Cheng Lina[10] ; Zhou Hui[11] ; Zhang Jiarui[1] ; Peng Lige[1] ; Pu Jiaqi[1] ; Zeng Jiaxin[1] ; Yi Qun[1,12] ; Zhou Haixia[1] ;
机构： [1]Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China [2]West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China [3]State Key Laboratory of Respiratory Disease, Guangzhou Medical University, Guangzhou, China [4]Department of Respiratory and Critical Care Medicine, People’s Hospital of Leshan, Leshan, China [5]Department of Respiratory and Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China [6]Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China [7]Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China [8]Department of Respiratory and Critical Care Medicine, The First People’s Hospital of Neijiang City, Neijiang, China [9]Department of Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, China [10]Department of Emergency, First People’s Hospital of Jiujiang, Jiujiang, China [11]Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Chengdu University, Chengdu, China [12]Sichuan Cancer Hospital, University of Electronic Science and Technology of China, Chengdu, China
出处：
DOI： 10.1159/000545267
ISSN：

关键词： Acute exacerbation of chronic obstructive pulmonary disease Systemic immune-inflammation index Neutrophil-to-lymphocyte ratio Platelet-to-lymphocyte ratio Prognosis

摘要：
Acute exacerbations of chronic obstructive pulmonary disease (AECOPDs) are associated with increased morbidity and mortality. The novel inflammatory biomarker, systemic immune-inflammation index (SII), may have prognostic value. This study aimed to assess the association between SII and short-term and long-term adverse outcomes among AECOPD inpatients.This was a multicenter, retrospective analysis of a prospectively collected cohort of AECOPD inpatients. We initially compared SII and other clinical characteristics between survivors and non-survivors during hospitalization, adjusting for primary comorbidities using propensity score matching (PSM). We assessed the short-term and long-term adverse outcomes, particularly focusing on in-hospital mortality and 2-year all-cause mortality, across different levels of SII. Multivariate Cox analysis was employed to evaluate the associations of SII, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) with in-hospital mortality of AECOPD patients. Restricted cubic spline (RCS) models investigated the nonlinear relationships between these biomarkers and in-hospital mortality. To compare the predictive values of SII, NLR, and PLR for in-hospital mortality, receiver operating characteristic (ROC) curve analysis was performed. Subgroup analysis was carried out to further determine the predictive capacity of SII among diverse subgroups.The study included 12,551 AECOPD inpatients, among whom 180 (1.4%) died in hospital. Whether before or after PSM adjusting for comorbidities, the levels of SII, NLR, and PLR in non-survivors were significantly higher than those in survivors (all p < 0.001). Elevated SII levels (divided into quartiles) were associated with increased in-hospital mortality (Q1 vs. Q2 vs. Q3 vs. Q4: 0.6% vs. 0.8% vs. 1.5% vs. 2.8%) and 2-year all-cause mortality (15.4% vs. 22.6% vs. 22.2% vs. 27.8%), as well as other adverse outcomes (all p < 0.05). After adjusting for covariates, higher levels of SII and NLR consistently remained associated with increased in-hospital mortality. RCS analysis revealed a consistent linear relationship between SII and in-hospital mortality, while NLR and PLR exhibited nonlinear relationships. Furthermore, ROC curve analysis indicated that SII showed inferiority to NLR but superiority to PLR in predicting in-hospital mortality among AECOPD patients (area under the curve for SII vs. NLR vs. PLR: 0.670 vs. 0.731 vs. 0.609). Subgroup analysis revealed that the association between SII and in-hospital mortality varied across different subgroups.Elevated SII is associated with increased risks of short-term and long-term adverse outcomes in AECOPD inpatients, making it potential prognostic factor used to identify high-risk patients and guide the management of AECOPD.© 2025 S. Karger AG, Basel.

基金：
Suzhou Collaborative Medical Health Foundation (Y117), the Key Research Program of China (2016YFC1304202), and the Sichuan Science and Technology Program (2022YFS0262).
语种：
外文
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出版当年[2025]版：
大类 | 3 区 医学
小类 | 3 区 呼吸系统
最新[2025]版：
大类 | 3 区 医学
小类 | 3 区 呼吸系统
JCR分区：
出版当年[2024]版：
Q1 RESPIRATORY SYSTEM
最新[2024]版：
Q1 RESPIRATORY SYSTEM

影响因子： 最新[2024版] 最新五年平均 出版当年[2024版] 出版当年五年平均 出版前一年[2024版]

第一作者：
第一作者机构： [1]Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
共同第一作者：
通讯作者：
通讯机构： [1]Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China [12]Sichuan Cancer Hospital, University of Electronic Science and Technology of China, Chengdu, China
推荐引用方式(GB/T 7714)：
Chen Xueqing,Liu Shiman,Luo Yuanming,et al.Systemic Immune-Inflammation Index Is Associated with Adverse Outcomes in Patients Hospitalized for AECOPD: A Multicenter Cohort Study[J].RESPIRATION.2025,104(9):648-666.doi:10.1159/000545267.
APA：
Chen Xueqing,Liu Shiman,Luo Yuanming,Wei Hailong,Ge Huiqing...&Zhou Haixia.(2025).Systemic Immune-Inflammation Index Is Associated with Adverse Outcomes in Patients Hospitalized for AECOPD: A Multicenter Cohort Study.RESPIRATION,104,(9)
MLA：
Chen Xueqing,et al."Systemic Immune-Inflammation Index Is Associated with Adverse Outcomes in Patients Hospitalized for AECOPD: A Multicenter Cohort Study".RESPIRATION 104..9(2025):648-666

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