Systemic Immune Inflammatory (SII) Index in Evaluating the Severity of Multitrauma Patients in the Emergency Department
Early alert marker; Systemic immune inflammatory index
Keywords:Systemic Immune-Inflammation Index, Multitrauma, early alert, emergency medicine
In the emergency department, healthcare providers face the critical task of assessing and managing patients with multitrauma, a condition characterized by multiple injuries sustained simultaneously. In this study, we evaluated the power of the systemic immune inflammatory index in predicting the prognosis and severity of patients admitted to the emergency department with multitrauma
Patients aged 18 years and older who presented to the adult emergency department of the hospital and were diagnosed with Multitrauma 1 January 2022 and 31 December 2022 were included in the study. Demographic characteristics (age and gender), initial laboratory test results including neutrophil (N), lymphocyte (L), and platelet counts, as well as NLR, PLO and SII will be calculated according to laboratory results; (NLR = neutrophil count / lymphocyte count ratio; PLR = platelet count / lymphocyte count ratio; SII = platelet count x neutrophil count / lymphocyte count ratio), hospital admission or intensive care unit (ICU) admission status, and patient outcomes were recorded from the medical records.
According to ROC analysis, NLR, PLR and SII parameters were statistically significant for the distinction between hospitalization and discharge (P<0.001, P:0.016 and P<0.001, respectively). When the data were categorized according to the cut-off values determined in the ROC analysis, NLR over 2.84 and SII over 777 were found to be significant for hospitalization according to the Chi-square analysis, while PLR over 108 was not significant (respectively P. <0.001, P:0.111 and P<0.001)
These markers provide valuable insights into the systemic inflammatory response and have the potential to aid in risk stratification, prognosis assessment, and treatment decision-making. However, further research is warranted to validate their utility in diverse patient populations and clinical scenarios.
Calleja, P., Aitken, L. M., & Cooke, M. (2020). Strategies to Improve Information Transfer for Multitrauma Patients. Clinical nursing research, 29(6), 398–410.
Ciechanowicz, D., Samojło, N., Kozłowski, J., Pakulski, C., & Żyluk, A. (2020). Incidence and etiology of mortality in polytrauma patients: an analysis of material from Multitrauma Centre of the University Teaching Hospital no 1 in Szczecin, over a period of 3 years (2017-2019). Polski przeglad chirurgiczny, 92(4), 1–6.
Köstek, M., Bostancı, Ö., Bilgiç, T., & Battal, M. (2022). Delayed diagnosis and successful management of completely transected common hepatic duct in a blunt multitrauma patient. Künt multi-travma olgusunda teşhisi gecikmiş tam kat ana hepatik kanal yaralanmasının başarılı yönetimi. Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 28(1), 116–119.
Lord, J. M., Midwinter, M. J., Chen, Y. F., Belli, A., Brohi, K., Kovacs, E. J., Koenderman, L., Kubes, P., & Lilford, R. J. (2014). The systemic immune response to trauma: an overview of pathophysiology and treatment. Lancet (London, England), 384(9952), 1455–1465.
Esenboğa, K., Kurtul, A., Yamantürk, Y. Y., Tan, T. S., & Tutar, D. E. (2022). Systemic immune-inflammation index predicts no-reflow phenomenon after primary percutaneous coronary intervention. Acta cardiologica, 77(1), 59–65.
B A Foëx, Systemic responses to trauma, British Medical Bulletin, Volume 55, Issue 4, 1999, Pages 726–743,
Giannoudis P. V. (2003). Current concepts of the inflammatory response after major trauma: an update. Injury, 34(6), 397–404
Vunvulea, V., Melinte, R. M., Brinzaniuc, K., Suciu, B. A., Ivănescu, A. D., Hălmaciu, I., Incze-Bartha, Z., Pastorello, Y., Trâmbițaș, C., Mărginean, L., Kaller, R., Kassas, A., & Hogea, T. (2023). Blood Count-Derived Inflammatory Markers Correlate with Lengthier Hospital Stay and Are Predictors of Pneumothorax Risk in Thoracic Trauma Patients. Diagnostics (Basel, Switzerland), 13(5), 954.
Chen L, Xia S, Zuo Y, Lin Y, Qiu X, Chen Q, Feng T, Xia X, Shao Q and Wang S (2023) Systemic immune inflammation index and peripheral blood carbon dioxide concentration at admission predict poor prognosis in patients with severe traumatic brain injury. Front. Immunol. 13:1034916. doi: 10.3389/fimmu.2022.1034916
Wang, ZC., Jiang, W., Chen, X. et al. Systemic immune-inflammation index independently predicts poor survival of older adults with hip fracture: a prospective cohort study. BMC Geriatr 21, 155 (2021).
Simon, D., Nascimento, R. I., Filho, E. M., Bencke, J., & Regner, A. (2016). Plasma brain-derived neurotrophic factor levels after severe traumatic brain injury. Brain injury, 30(1), 23–28.
de Fraiture, E. J., Vrisekoop, N., Leenen, L. P. H., van Wessem, K. J. P., Koenderman, L., & Hietbrink, F. (2022). Longitudinal assessment of the inflammatory response: The next step in personalized medicine after severe trauma. Frontiers in medicine, 9, 983259.
Kawalec AM. The systemic immune-inflammation index and neutrophil-lymphocyte ratio in pediatric burned patients – a pilot study. Pediatria Polska - Polish Journal of Paediatrics. 2023;98(1):8-11. doi:10.5114/polp.2023.125959.
Kart Y. , Uğur C. Evaluation of Systemic Immune-Inflammation Index as Novel Marker in the Diagnosis of Acute Appendicitis in Children. J Contemp Med. 2022; 12(5): 593-597.
He, K., Si, L., Pan, X., Sun, L., Wang, Y., Lu, J., & Wang, X. (2022). Preoperative Systemic Immune-Inflammation Index (SII) as a Superior Predictor of Long-Term Survival Outcome in Patients With Stage I-II Gastric Cancer After Radical Surgery. Frontiers in oncology, 12, 829689.
Huang, Y., Gao, Y., Wu, Y. et al. Prognostic value of systemic immune-inflammation index in patients with urologic cancers: a meta-analysis. Cancer Cell Int 20, 499 (2020).
Şebnem Nergiz, Önder Öztürk Relationship Between Systemic Immune Inflammation Index and Prognosis in Patients with COVID-19 Dicle Tıp Dergisi / Dicle Med J (2022) 49 (4) : 612-618
Margraf, A., Ludwig, N., Zarbock, A., & Rossaint, J. (2020). Systemic Inflammatory Response Syndrome After Surgery: Mechanisms and Protection. Anesthesia and analgesia, 131(6), 1693–1707.
How to Cite
Copyright (c) 2023 Chronicles of Precision Medical Researchers
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.