A predictive model for poor prognosis based on systemic immune inflammation index,erythrocyte sedi-mentation rate nd serum inflammatory factors in patients with infective endocarditis
Zhang Xiaomeng
Zhang Wei
Wang Hui
Shi Xiaohui
Yang Shuting
Zong Yuzhen
Abstract：Objective To investigate the characteristics of expressions of systemic immune inflammation index(SII),erythrocyte sedimentation rate(ESR)and serum inflammatory factors in patients with infective endocarditis(IE),and to establish a predictive model for poor prognosis.Methods IE patients(n=144)were chosen from People's Hospital,Xinjiang Uygur Autonomous Region from Jan 2021 to Mar.2023.All patients were divided,according to prognosis status within 6 months after treated,into good prognosis group(n=1 12)and poor prognosis group(n=32).The general clinical materials[age,gender,body mass index(BMI),history of smoking,drinking,hypertension and type 2 diabetes mellitus(T2DM),position and number of involved heart valves,heart function classification of New York Heart Association(NYHA grades),time from disease onset to hospital visit,and inflammatory indexes[ESR,interleukin-6(IL-6),interleukin-8(IL-8),procalcitonin(PCT),C-reactive protein(CRP),prognostic nutrition index(PNI)and SII]were compared between 2 groups.The risk factors of poor prognosis were screened by using Spearman correlation analysis,and Logistic regression analysis and a predictive model was established.The efficacy and accuracy of the predictive model were reviewed by using ROC curve analysis,calibration curve and decision curve analysis(DCA).Results The percentages of T2DM and grades Ⅲ to Ⅳ of NYHA were significantly higher(P＜0.05),levels of ESR,IL-6,PCT and SII were significantly higher(P＜0.05),and PNI level was significantly lower(P＜0.05)in poor prognosis group.The results of Spearman correlation analysis showed that T2DM(r=0.166,P=0.047),grades Ⅲ to Ⅳ of NYHA(r=0.168,P=0.044),ESR(r=0.381,P＜0.001),IL-6(r=0.281,P=0.001),PCT(r=0.227,P=0.006)and SII(r=0.323,P＜0.001)were positively correlated to poor prognosis,and PNI(r=-0.324,P＜0.001)was negatively correlated to poor prognosis.The results of Logistic regression analysis showed that higher levels of ESR(OR=1.17,95％CI:1.02～1.96,P=0.043),IL-6(OR=1.18,95％CI:1.02～1.86,P=0.047),PCT(OR=5.92,95％CI:1.94～7.30,P=0.038)and SII(OR=1.21,95％CI:1.01～3.01,P=0.003),and lower PNI level(OR=0.86,95％CI:0.77～0.95,P=0.006)all were risk factors of poor prognosis.The results of ROC curve calibration curve and DC A analyses showed that AUC was 0.892(0.827～0.957)with higher predictive efficacy and accuracy.Conclusion The higher levels of ESR,IL-6,PCT and SII and lower PNI level are important indexes for predicting poor prognosis in IE patients.The risk predictive model established based on above indexes related to inflammation and nutritional level has some application value to prognosis reviewing in IE patients.
Keywords：Infective endocarditisSystemic immune inflammation indexInflammatory factorsPrognosis review
Publication Date：2024-10-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 1203-1207 )