The Significance of Systemic Immune-Inflammatory Index for Mortality Prediction in Diabetic Patients Treated with Off-Pump Coronary Artery Bypass Surgery
Abstract
:1. Introduction
2. Materials and Methods
Statistical Analysis
3. Results
3.1. All Groups
3.2. Diabetic Group
3.3. Receiver Operator Characteristics for Postoperative Inflammatory Markers Revealed in Multivariable Analysis
3.4. Receiver Operator Curve for Postoperative Inflammatory Markers, including Components of the SII
3.5. Univariable Analysis
3.6. Multivariable Analysis
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Parameters | DM Group (No. = 175) | Non-DM Group (No. = 335) | p |
---|---|---|---|
Demographical data: | |||
1. Age (years) (median (Q1–Q3)) | 67 (61–73) | 64 (59–70) | 0.002 * |
2. Gender (F (%)/M (%)) | 42 (24%)/133 (76%) | 57 (17%)/278 (83%) | 0.058 |
Comorbidities: | |||
1. Arterial hypertension (median (Q1–Q3)) | 36 (21%) | 97 (29%) | 0.041 * |
2. COPD (median (Q1–Q3)) | 12 (97%) | 32 (10%) | 0.716 |
3. Hypercholesterolemia (median (Q1–Q3)) | 77 (44%) | 219 (65%) | <0.001 * |
4. PAD (median (Q1–Q3)) | 27 (15%) | 52 (16%) | 0.967 |
Echocardiographic estimation of LVEF: | |||
1. Preoperative (%) (median (Q1–Q3)) | 55 (50–60) | 55 (50–60) | 0.349 |
2. Postoperative (%) (median (Q1–Q3)) | 55 (50–60) | 60 (50–60) | 0.773 |
Parameters | DM Group (No. = 175) | Non-DM Group (No. = 335) | p |
---|---|---|---|
Preoperative laboratory results: | |||
A. Whole blood count: | |||
1. WBC × 109/L (median (Q1–Q3)) | 7.7 (6.5–9.3) | 7.8 (6.4–9.2) | 0.979 |
2. Lymphocyte × 109/L (median (Q1–Q3)) | 1.8 (1.5–2.3) | 1.8 (1.4–2.2) | 0.415 |
3. Neutrophils × 109/L (median (Q1–Q3)) | 5.0 (4.0–6.2) | 5.1 (4.0–6.3) | 0.748 |
4. Monocytes × 109/L (median (Q1–Q3)) | 0.5 (0.4–0.6) | 0.5 (0.4–0.6) | 0.828 |
5. Hemoglobin × 109/L (median (Q1–Q3)) | 8.6 (8–9.2) | 8.7 (8.3–9.3) | 0.147 |
6. Platelets × 103/μL (median (Q1–Q3)) | 225 (189–270) | 228 (192–264) | 0.819 |
B. Hematologic indexes: | |||
1. SIRI (median (Q1–Q3)) | 1.3 (0.8–1.9) | 1.3 (0.9–1.9) | 0.483 |
2. SII (median (Q1–Q3)) | 634 (431–916) | 619 (425–914) | 0.649 |
3. AISI (median (Q1–Q3)) | 280 (178–470) | 287 (172–440) | 0.764 |
C. Myocardial injury: | |||
Troponin on admission × 109/L (median (Q1–Q3)) | 0.01 (0.01–0.03) | 0.01 (0.01–0.02) | 0.527 |
D. Kidney function: | |||
Creatinine × 109/L (median (Q1–Q3)) | 86 (76–106) | 85 (71–99) | 0.096 |
Postoperative laboratory results (24 h): | |||
A. Whole blood count: | |||
7. WBC × 109/L (median (Q1–Q3)) | 8.6 (6.9–10.3) | 8.4 (7–10.4) | 0.925 |
8. Lymphocyte × 109/L (median (Q1–Q3)) | 1.9 (1.5–2.5) | 1.9 (1.5–2.5) | 0.983 |
9. Neutrophils × 109/L (median (Q1–Q3)) | 5.1 (3.8–6.6) | 4.9 (3.7–6.5) | 0.613 |
10. Monocytes × 109/L (median (Q1–Q3)) | 0.84 (0.7–1.1) | 0.9 (0.7–1.1) | 0.587 |
11. Hemoglobin mmol/L (median (Q1–Q3)) | 6.9 (6.6–7.3) | 6.8 (6.5–7.2) | 0.082 |
12. Platelets × 103/μL (median (Q1–Q3)) | 273 (227–341) | 283 (229–350) | 0.662 |
B. Hematologic indexes: | |||
4. SIRI (median (Q1–Q3)) | 4.3 (2.6–7.1) | 4.2 (2.8–6.0) | 0.556 |
5. SII (median (Q1–Q3)) | 699 (507–1062) | 741 (497–1096) | 0.846 |
6. AISI (median (Q1–Q3)) | 616 (391–1030) | 634 (390–1088) | 0.729 |
C. Myocardial injury: | |||
Troponin on admission μmg/L (median (Q1–Q3)) | 1.5 (0.7–3.5) | 1.6 (0.7–3.8) | 0.615 |
D. Kidney function: | |||
Creatinine mmol/L (median (Q1–Q3)) | 96 (79–124) | 86 (71–107) | 0.048 * |
Number of performed grafts (median (Q1–Q3)) | 2.3 (2.0–2.6) | 2.3 (2.1–2.5) | 0.782 |
All-cause mortality during observation time (%) | 16 (9%) | 27 (8%) | 0.817 |
Parameters | DM Deaths (No. = 16) | DM Survivors (No. = 159) | p |
---|---|---|---|
Age (years) (median (Q1–Q3)) | 70 (65–76) | 67 (61–73) | 0.097 |
Gender (F (%)/M (%)) | 5 (31%)/11 (69%) | 37 (23%)/122 (77%) | 0.476 |
Comorbidities: | |||
1. Arterial hypertension (%) | 2 (13%) | 34 (21%) | 0.402 |
2. COPD (%) | 4 (25%) | 11 (7%) | 0.014 * |
3. Stroke (%) | 6 (38%) | 7 (4%) | <0.001 * |
4. Hypercholesterolemia (%) | 6 (38%) | 71 (45%) | 0.583 |
5. PAD (%) | 6 (38%) | 21 (13%) | 0.010 * |
Preoperative: | |||
1. WBC × 109/L (median (Q1–Q3)) | 7.6 (6.9–8.8) | 7.73 (6.5–9.3) | 0.709 |
2. Lymphocytes × 109/L (median (Q1–Q3)) | 1.6 (1.1–2.0) | 1.8 (1.5–2.3) | 0.105 |
3. Neutrophils × 109/L (median (Q1–Q3)) | 5.5 (4.4–6.5) | 5 (4.0–6.2) | 0.399 |
4. Monocytes × 109/L (median (Q1–Q3)) | 0.5 (0.3–0.5) | 0.5 (0.4–0.6) | 0.589 |
5. Hemoglobin mmol/L (median (Q1–Q3)) | 8.4 (7.5–9.4) | 8.6 (8.1–9.2) | 0.409 |
6. Platelets × 103/μL (median (Q1–Q3)) | 234 (209–278) | 224 (189–270) | 0.566 |
Postoperative (24 h): | |||
1. WBC × 109/L (median (Q1–Q3)) | 9.3 (7.6–12) | 8.4 (6.7–10) | 0.107 |
2. Lymphocytes × 109/L (median (Q1–Q3)) | 1.7 (1.2–2.1) | 1.9 (1.6–2.5) | 0.055 |
3. Neutrophils × 109/L (median (Q1–Q3)) | 6.2 (5–7.9) | 5 (3.7–6.4) | 0.007 * |
4. Monocytes × 109/L (median (Q1–Q3)) | 1 (0.6–1.1) | 0.8 (0.7–1.1) | 0.798 |
5. Hemoglobin mmol/L (median (Q1–Q3)) | 6.9 (6.6–7.2) | 6.9 (6.6–7.3) | 0.881 |
6. Platelets × 103/L (median (Q1–Q3)) | 271 (231–327) | 273 (227–341) | 0.854 |
Preoperative indexes: | |||
1. SIRI (median (Q1–Q3)) | 1.5 (1–2.2) | 1.2 (0.8–1.9) | 0.223 |
2. SII (median (Q1–Q3)) | 839 (611–1068) | 617 (422–904) | 0.059 |
3. AISI (median (Q1–Q3)) | 355 (217–537) | 267 (172–450) | 0.183 |
Postoperative indexes: | |||
1. SIRI (median (Q1–Q3)) | 5.5 (3.5–9.6) | 4.1 (2.6–6.7) | 0.150 |
2. SII (median (Q1–Q3)) | 1097 (679–1956) | 686 (495–1015) | 0.008 * |
3. AISI (median (Q1–Q3)) | 1094 (495–1704) | 602 (358–978) | 0.045 * |
Troponin-I: | |||
1. On admission mcg/L (median (Q1–Q3)) | 0.01 (0.01–0.01) | 0.01 (0.01–0.03) | 0.867 |
2. Maximum mcg/L (median (Q1–Q3)) | 2.6 (0.6–5.0) | 1.5 (0.7–3.1) | 0.539 |
Creatinine | |||
1. Preoperative mmol/L (median (Q1–Q3)) | 97 (83–136) | 86 (75–102) | 0.232 |
2. Postoperative mmol/L (median (Q1–Q3)) | 102 (84–145) | 96 (78–116) | 0.351 |
LVEF: | |||
1. Preoperative (%) (median (Q1–Q3)) | 55 (50–60) | 47 (43–51) | 0.504 |
2. Postoperative (%) (median (Q1–Q3)) | 55 (45–55) | 60 (50–60) | 0.091 |
Parameter | HR | 95% CI | p-Value |
---|---|---|---|
Demographical and clinical: | |||
1. Age | 1.09 | 1.01–1.17 | 0.027 * |
2. Stroke | 7.25 | 2.47–21.27 | <0.001 * |
3. PAD | 4.35 | 1.51–12.55 | 0.050 * |
Preoperative laboratory parameters: | |||
1. SIRI | 1.03 | 0.79–1.34 | 0.830 |
2. SII | 1.00 | 1.00–1.00 | 0.555 |
3. SII > 665 | 2.45 | 0.77–7.85 | 0.131 |
4. AISI | 1.00 | 0.99–1.01 | 0.896 |
Preoperative laboratory parameters: | |||
1. Neutrophils postoperatively | 1.24 | 1.05–1.46 | 0.010 * |
2. SIRI | 1.07 | 0.94–1.20 | 0.299 |
3. SII | 3.43 | 1.00–1.00 | 0.001 * |
4. SII > 952 | 5.23 | 1.64–16.68 | 0.005 * |
5. AISI | 1.00 | 0.99–1.00 | 0.091 |
6. AISI > 1030 | 4.00 | 1.39–11.55 | 0.010 * |
Postoperative LVEF | 0.90 | 0.86–0.95 | <0.001 * |
Parameter | HR | 95% CI | p-Value |
---|---|---|---|
Clinical characteristics: | |||
1. Stroke | 3.39 | 1.06–10.91 | 0.040 * |
2. PAD | 3.83 | 1.27–11.56 | 0.017 * |
Laboratory results: | |||
SII post > 952 | 3.44 | 1.02–11.66 | 0.047 * |
Echocardiographic: | |||
LVEF < 45% postoperatively | 4.11 | 1.21–13.95 | 0.023 * |
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Urbanowicz, T.; Michalak, M.; Al-Imam, A.; Olasińska-Wiśniewska, A.; Rodzki, M.; Witkowska, A.; Haneya, A.; Buczkowski, P.; Perek, B.; Jemielity, M. The Significance of Systemic Immune-Inflammatory Index for Mortality Prediction in Diabetic Patients Treated with Off-Pump Coronary Artery Bypass Surgery. Diagnostics 2022, 12, 634. https://doi.org/10.3390/diagnostics12030634
Urbanowicz T, Michalak M, Al-Imam A, Olasińska-Wiśniewska A, Rodzki M, Witkowska A, Haneya A, Buczkowski P, Perek B, Jemielity M. The Significance of Systemic Immune-Inflammatory Index for Mortality Prediction in Diabetic Patients Treated with Off-Pump Coronary Artery Bypass Surgery. Diagnostics. 2022; 12(3):634. https://doi.org/10.3390/diagnostics12030634
Chicago/Turabian StyleUrbanowicz, Tomasz, Michał Michalak, Ahmed Al-Imam, Anna Olasińska-Wiśniewska, Michał Rodzki, Anna Witkowska, Assad Haneya, Piotr Buczkowski, Bartłomiej Perek, and Marek Jemielity. 2022. "The Significance of Systemic Immune-Inflammatory Index for Mortality Prediction in Diabetic Patients Treated with Off-Pump Coronary Artery Bypass Surgery" Diagnostics 12, no. 3: 634. https://doi.org/10.3390/diagnostics12030634