Yeliz Guler, Omer Genc, Furkan Akbas, Abdullah Yildirim, Ilyas Cetin, Aslan Erdogan, Ufuk S Halil, Huseyin Akgun, Berat Erdem, Ahmet Guler, Cevat Kirma
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The Naples prognostic score (NPS), pan-immune inflammation value (PIV), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) were calculated. Discrimination and decision curve analyses were used to explore the link between inflammation and wound healing.</p><p><strong>Results: </strong>Wound healing was observed in 142 (76.8%) patients post-EVT. Nonhealing patients exhibited higher indices of NPS, PIV, SII, and SIRI. NPS (aOR = 0.381, 95% CI 0.215-0.675, <i>p</i> = 0.001), PIV (aOR = 0.997, 95% CI 0.996-0.999, <i>p</i> < 0.001), SII (aOR = 0.997, 95% CI 0.996-0.997, <i>p</i> < 0.001), and SIRI (aOR = 0.443, 95% CI 0.313-0.625, <i>p</i> < 0.001) were independently predictive of wound healing. SIRI (AUC = 0.840, 95% CI 0.777-0.904) demonstrated superior predictive ability compared to PIV (AUC = 0.799, 95% CI 0.722-0.876, <i>p</i>dif < 0.001), SII (AUC = 0.788, 95% CI 0.712-0.865, <i>p</i>dif < 0.001), and NPS (AUC = 0.760, 95% CI 0.681-0.838, <i>p</i>dif < 0.001). SIRI also showed higher net reclassification improvement over PIV (68.4%, <i>p</i>dif < 0.001), SII (38.5%, <i>p</i>dif = 0.024), and NPS (29.8%, <i>p</i>dif = 0.079). All inflammatory indices, especially SIRI, provided prognostic value in determining wound healing at high treatment thresholds (> 40%).</p><p><strong>Conclusion: </strong>In patients with CLTI undergoing EVT, SIRI, SII, PIV, and NPS may help predict the potential for wound healing during in-hospital follow up, with SIRI being the strongest predictor.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"186-196"},"PeriodicalIF":2.7000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Predictive value of the inflammatory indices on wound healing in patients with chronic limb-threatening ischemia revascularized via percutaneous intervention.\",\"authors\":\"Yeliz Guler, Omer Genc, Furkan Akbas, Abdullah Yildirim, Ilyas Cetin, Aslan Erdogan, Ufuk S Halil, Huseyin Akgun, Berat Erdem, Ahmet Guler, Cevat Kirma\",\"doi\":\"10.1177/1358863X251320867\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Peripheral artery disease (PAD) is a common manifestation of atherosclerosis. Despite the effectiveness of endovascular therapy (EVT), patients with PAD often face poor prognoses. This study investigates the relationship between specific inflammatory indices and wound healing in patients with Fontaine stage 4 chronic limb-threatening ischemia (CLTI).</p><p><strong>Methods: </strong>From June 2021 to January 2024, 168 patients with Fontaine stage 4 CLTI, totaling 185 affected extremities, who underwent successful EVT, were assessed retrospectively. Patients were categorized based on wound healing post-EVT. The Naples prognostic score (NPS), pan-immune inflammation value (PIV), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) were calculated. Discrimination and decision curve analyses were used to explore the link between inflammation and wound healing.</p><p><strong>Results: </strong>Wound healing was observed in 142 (76.8%) patients post-EVT. Nonhealing patients exhibited higher indices of NPS, PIV, SII, and SIRI. NPS (aOR = 0.381, 95% CI 0.215-0.675, <i>p</i> = 0.001), PIV (aOR = 0.997, 95% CI 0.996-0.999, <i>p</i> < 0.001), SII (aOR = 0.997, 95% CI 0.996-0.997, <i>p</i> < 0.001), and SIRI (aOR = 0.443, 95% CI 0.313-0.625, <i>p</i> < 0.001) were independently predictive of wound healing. SIRI (AUC = 0.840, 95% CI 0.777-0.904) demonstrated superior predictive ability compared to PIV (AUC = 0.799, 95% CI 0.722-0.876, <i>p</i>dif < 0.001), SII (AUC = 0.788, 95% CI 0.712-0.865, <i>p</i>dif < 0.001), and NPS (AUC = 0.760, 95% CI 0.681-0.838, <i>p</i>dif < 0.001). SIRI also showed higher net reclassification improvement over PIV (68.4%, <i>p</i>dif < 0.001), SII (38.5%, <i>p</i>dif = 0.024), and NPS (29.8%, <i>p</i>dif = 0.079). 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引用次数: 0
摘要
外周动脉疾病（PAD）是动脉粥样硬化的常见表现。尽管血管内治疗（EVT）有效，但PAD患者往往面临不良预后。本研究探讨Fontaine期慢性肢体威胁缺血（CLTI）患者特异性炎症指标与创面愈合的关系。方法：从2021年6月至2024年1月，对168例成功行EVT的Fontaine 4期CLTI患者，共185条患肢进行回顾性评估。根据evt后的伤口愈合情况对患者进行分类。计算那不勒斯预后评分（NPS）、泛免疫炎症值（PIV）、全身免疫炎症指数（SII）和全身炎症反应指数（SIRI）。鉴别和决策曲线分析用于探讨炎症和伤口愈合之间的联系。结果：142例evt术后创面愈合，占76.8%。未愈合患者NPS、PIV、SII、SIRI指数较高。NPS （aOR = 0.381, 95% CI 0.215-0.675, p = 0.001）、PIV （aOR = 0.997, 95% CI 0.996-0.999, p < 0.001）、SII （aOR = 0.997, 95% CI 0.996-0.997, p < 0.001）和SIRI （aOR = 0.443, 95% CI 0.313-0.625, p < 0.001）是独立预测伤口愈合的指标。与PIV （AUC = 0.799, 95% CI 0.722-0.876, pdif < 0.001）、SII （AUC = 0.788, 95% CI 0.712-0.865, pdif < 0.001）和NPS （AUC = 0.760, 95% CI 0.681-0.838, pdif < 0.001）相比，SIRI （AUC = 0.840, 95% CI 0.777- 0.876, pdif < 0.001）表现出更强的预测能力。SIRI也比PIV （68.4%, pdif < 0.001）、SII （38.5%, pdif = 0.024）和NPS （29.8%, pdif = 0.079）表现出更高的净重分类改善。所有炎症指标，尤其是SIRI，在高治疗阈值（bbb40 %）下，对确定伤口愈合具有预后价值。结论：在行EVT的CLTI患者中，SIRI、SII、PIV和NPS可能有助于预测住院随访期间伤口愈合的潜力，其中SIRI是最强的预测因子。
Predictive value of the inflammatory indices on wound healing in patients with chronic limb-threatening ischemia revascularized via percutaneous intervention.
Introduction: Peripheral artery disease (PAD) is a common manifestation of atherosclerosis. Despite the effectiveness of endovascular therapy (EVT), patients with PAD often face poor prognoses. This study investigates the relationship between specific inflammatory indices and wound healing in patients with Fontaine stage 4 chronic limb-threatening ischemia (CLTI).
Methods: From June 2021 to January 2024, 168 patients with Fontaine stage 4 CLTI, totaling 185 affected extremities, who underwent successful EVT, were assessed retrospectively. Patients were categorized based on wound healing post-EVT. The Naples prognostic score (NPS), pan-immune inflammation value (PIV), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) were calculated. Discrimination and decision curve analyses were used to explore the link between inflammation and wound healing.
Results: Wound healing was observed in 142 (76.8%) patients post-EVT. Nonhealing patients exhibited higher indices of NPS, PIV, SII, and SIRI. NPS (aOR = 0.381, 95% CI 0.215-0.675, p = 0.001), PIV (aOR = 0.997, 95% CI 0.996-0.999, p < 0.001), SII (aOR = 0.997, 95% CI 0.996-0.997, p < 0.001), and SIRI (aOR = 0.443, 95% CI 0.313-0.625, p < 0.001) were independently predictive of wound healing. SIRI (AUC = 0.840, 95% CI 0.777-0.904) demonstrated superior predictive ability compared to PIV (AUC = 0.799, 95% CI 0.722-0.876, pdif < 0.001), SII (AUC = 0.788, 95% CI 0.712-0.865, pdif < 0.001), and NPS (AUC = 0.760, 95% CI 0.681-0.838, pdif < 0.001). SIRI also showed higher net reclassification improvement over PIV (68.4%, pdif < 0.001), SII (38.5%, pdif = 0.024), and NPS (29.8%, pdif = 0.079). All inflammatory indices, especially SIRI, provided prognostic value in determining wound healing at high treatment thresholds (> 40%).
Conclusion: In patients with CLTI undergoing EVT, SIRI, SII, PIV, and NPS may help predict the potential for wound healing during in-hospital follow up, with SIRI being the strongest predictor.
期刊介绍：
The premier, ISI-ranked journal of vascular medicine. Integrates the latest research in vascular biology with advancements for the practice of vascular medicine and vascular surgery. It features original research and reviews on vascular biology, epidemiology, diagnosis, medical treatment and interventions for vascular disease. A member of the Committee on Publication Ethics (COPE)
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