Relationship between SII,SIRI,and FAR with disease severity and coexisting active pulmonary tuberculosis in pa-tients with acute exacerbation of bronchiectasis
Meng Shanshan
Wang Dan
Yu Jie
Hu Xin
Yu Shihuan
Abstract：Objective To investigate the relationship between systemic immune-inflammation index(SII),systemic inflammation response index(SIRI),fibrinogen-to-albumin ratio(FAR),and disease severity as well as coexisting active pul-monary tuberculosis(APTB)in patients with acute exacerbation of bronchiectasis(AEBE).Methods A retrospective analysis was conducted on 206 AEBE patients admitted to the Department of Respiratory and Critical Care Medicine,The First Affilia-ted Hospital of Harbin Medical University between January 2019 and May 2024.Based on bronchiectasis severity index(BSI)scores,patients were categorized into mild(n=72),moderate(n=55),and severe(n=79)AEBE groups.They were also divid-ed into APTB group(n=62)and non-APTB group(n=144)according to APTB presence.Clinical data were collected,and SII,SIRI,and FAR were calculated.Spearman correlation analyzed associations between SII,SIRI,FAR and BSI scores.Uni-variate and multivariate logistic regression identified factors associated with AEBE-APTB comorbidity and constructed a no-mogram prediction model.The Hosmer-Lemeshow test assessed model fit,while ROC curve,C-index,calibration curve,and decision curve analysis evaluated model performance,discrimination,calibration,and clinical utility.Results SII,SIRI,and FAR levels progressively increased with disease severity across mild,moderate,and severe AEBE groups(F/P=136.677/＜0.001,200.878/＜0.001,86.227/＜0.001).Compared with non-APTB group,APTB group had older age,higher BSI scores,higher hemoptysis proportion,and elevated SII,SIRI and FAR levels(x2/t/P=3.408/0.001,4.545/＜0.001,7.937/0.005,6.101/＜0.001,4.972/＜0.001,5.535/＜0.001).Spearman correlation showed SII,SIRI,and FAR were positively correlated with BSI scores(rs/P=0.624/＜0.001,0.696/＜0.001,0.606/＜0.001).Multivariate logistic regression identified older age,high BSI score,hemoptysis,high SII,high SIRI and high FAR as independent risk factors for APTB in AEBE patients[OR(95％CI)=1.067(1.016-1.121),1.107(1.053-1.165),4.177(1.645-10.606),1.003(1.001-1.004),1.274(1.075-1.509),1.280(1.133-1.447)].A nomogram prediction model was constructed and showed good fit(Hosmer-Lemeshow P＞0.05).The AUC for predicting APTB was 0.888(95％CI:0.837-0.928),with C-index of 0.888(95％CI:0.869-0.895).Calibration curves showed good con-sistency between predicted and actual probabilities.Decision curve analysis demonstrated positive net clinical benefit when threshold probability was＞0.08.Conclusion Elevated SII,SIRI,and FAR levels are associated with disease severity and APTB in AEBE patients.The nomogram model based on these indicators demonstrates high predictive value for AEBE pa-tients with APTB.
Keywords：Acute exacerbation of bronchiectasisSystemic immune-inflammation indexSystemic inflammation re-sponse indexFibrinogen-to-albumin ratioDisease severityActive pulmonary tuberculosis
Publication Date：2025-10-18
Online Publishing Date：2025-11-10(First online date of this platform, not the publication date of the document)
Pages：7( 1166-1172 )