The predictive value of the systemic immune inflammatory index for acute lung injury after severe traumatic brain injury
10.3760/cma.j.cn114656-20250115-00039
- VernacularTitle:系统性免疫炎症指数对重型颅脑损伤后肺损伤的预测价值
- Author:
Ke XIE
1
;
Cuicui SHI
;
Xue SUN
;
Liqin HU
;
Xiong LIU
;
Xin LU
;
Zhang BU
;
Peng YANG
;
Feng XU
;
Xionghui CHEN
Author Information
1. 苏州大学附属第一医院急诊医学科，苏州大学创伤医学研究所，江苏省创伤医学创新中心，苏州 215006
- Keywords:
Severe traumatic brain injury;
Systemic immune inflammation index;
Acute lung injury;
Prognosis
- From:
Chinese Journal of Emergency Medicine
2025;34(9):1199-1205
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the diagnostic and prognostic value of systemic immune inflammatory index (SII) for severe traumatic brain injury secondary to acute lung injury (sTBI-ALI).Methods:A retrospective study was conducted on patients with severe traumatic brain injury admitted to the trauma center of the First Affiliated Hospital of Soochow University from January 2021 to November 2023. Patients received standard treatments including hemostasis and intracranial pressure management. Vital signs and blood routine data were collected upon admission. Patients were categorized into sTBI group and sTBI-ALI group based on established clinical diagnostic criteria for ALI to evaluate the diagnostic utility of SII. Subsequently, within the sTBI-ALI group, patients were stratified into survival and non-survival groups based on their 30-day outcomes to assess the prognostic value of SII.Results:A total of 260 sTBI patients were enrolled, of whom 113 developed ALI. Among the sTBI-ALI patients, 73 survived at 30 days. Compared to the sTBI group, the sTBI-ALI group exhibited significantly higher respiratory rates, heart rates, white blood cell counts, neutrophil counts, platelet counts, and SII levels (all P<0.05). Multivariate logistic regression analysis showed that SII index ( OR=1.003, 95% CI: 1.002-1.004, P<0.001) was an independent risk factor for ALI development in sTBI patients. The combined predictive model incorporating SII and heart rate yielded an AUC of 0.801 (95% CI: 0.740-0.862). The non-survival group had significantly higher neutrophil counts and SII levels, and significantly lower Glasgow Coma Scale scores than the survival group (all P<0.05). Multifactorial regression analysis indicated that SII index ( OR=1.002, P=0.004, 95% CI: 1.000-1.003) served as an independent risk factor for 30-day mortality in sTBI-ALI patients. The combined predictive model of SII and GCS achieved an AUC of 0.904 (95% CI: 0.848-0.960). Conclusions:SII demonstrates potential as a biomarker for predicting the development of ALI following sTBI. Furthermore, incorporating SII into predictive models significantly enhances the ability to forecast mortality risk in sTBI-ALI patients.
