Systemic Immune-Inflammation Index Predicts Prolonged Mechanical Ventilation and Intensive Care Unit Stay After off-Pump Coronary Artery Bypass Graft Surgery: A Single-Center Retrospective Study.
I Made Adi Parmana, Cindy Elfira Boom, Herdono Poernomo, Chairil Gani, Budi Nugroho, Riza Cintyandy, Lisa Sanjaya, Yudi Hadinata, Dian Raseka Parna, Dudy Arman Hanafy
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引用次数: 3
Abstract
Purpose: Coronary artery disease (CAD) is the primary cause of mortality in developing countries. Off-pump coronary artery bypass grafting (OPCAB) offers more upside in revascularization by preventing cardiopulmonary bypass trauma and minimizing aortic manipulation. Even though cardiopulmonary bypass is not involved, OPCAB still causes a significant systemic inflammatory response. This study determines the prognostic values of the systemic immune-inflammation index (SII) towards perioperative outcomes in patients who underwent OPCAB surgery.
Patients and methods: This was a single-center retrospective study at the National Cardiovascular Center Harapan Kita, Jakarta, using secondary data from electronic medical records and medical record archives of all patients who underwent OPCAB from January 2019 through December 2021. A total of 418 medical records were obtained, and 47 patients were excluded based on the exclusion criteria. The values of SII were calculated from preoperative laboratory data of segmental neutrophil count, lymphocyte count, and platelet count. Patients were divided into two groups based on the SII cutoff value of 878.056 x 103/mm3.
Results: The baseline SII values of 371 patients were calculated, among which 63 (17%) patients had preoperative SII values of ≥878.057 x 103/mm3. High SII values were a significant predictor of prolonged ventilation (RR 1.141, 95% CI 1.001-1.301) and prolonged ICU stay (RR 1.218, 95% CI 1.021-1.452) after OPCAB surgery. A positive correlation was observed between SII and hospital length of stay after OPCAB surgery. From the receiver operating characteristic curve analysis, SII predicted prolonged ventilation duration, with an area under the curve of 0.658 (95% CI 0.575-0.741, p = 0.001).
Conclusion: High preoperative SII values are capable of predicting prolonged mechanical ventilation and intensive care unit stay after OPCAB surgery.
目的:冠状动脉疾病(CAD)是发展中国家死亡的主要原因。非体外循环冠状动脉旁路移植术(OPCAB)通过防止体外循环创伤和减少主动脉操作，在血运重建方面具有更大的优势。即使不涉及体外循环，OPCAB仍会引起显著的全身炎症反应。本研究确定了全身免疫炎症指数(SII)对OPCAB手术患者围手术期预后的预测价值。患者和方法:这是雅加达国家心血管中心Harapan Kita的一项单中心回顾性研究，使用了2019年1月至2021年12月期间接受OPCAB的所有患者的电子病历和病历档案中的辅助数据。共获得418份病历，根据排除标准排除47例患者。SII的值是根据术前实验室数据的节段性中性粒细胞计数、淋巴细胞计数和血小板计数计算的。根据SII截断值878.056 × 103/mm3将患者分为两组。结果:计算371例患者的基线SII值，其中63例(17%)患者术前SII值≥878.057 x 103/mm3。高SII值是OPCAB术后延长通气时间(RR 1.141, 95% CI 1.001-1.301)和延长ICU住院时间(RR 1.218, 95% CI 1.021-1.452)的重要预测因子。SII与OPCAB术后住院时间呈正相关。从受试者工作特征曲线分析来看，SII预测通气时间延长，曲线下面积为0.658 (95% CI 0.575-0.741, p = 0.001)。结论:术前高SII值能够预测OPCAB术后延长机械通气时间和重症监护病房时间。
期刊介绍：
An international, peer-reviewed journal of therapeutics and risk management, focusing on concise rapid reporting of clinical studies on the processes involved in the maintenance of vascular health; the monitoring, prevention, and treatment of vascular disease and its sequelae; and the involvement of metabolic disorders, particularly diabetes. In addition, the journal will also seek to define drug usage in terms of ultimate uptake and acceptance by the patient and healthcare professional.
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