What is the clinical evidence from this study?

Study design: Observational. Population: Sepsis (n=401). Intervention: Systemic inflammatory response index (SIRI) vs. Lower SIRI levels (≤ 6.1). Primary outcome: Prognosis of sepsis (improvement or deterioration/death) (OR 1.981, 95% CI 1.255-3.126, p=<0.001).

January 14, 2025Open Access

Systemic inflammatory response index improves prognostic predictive value in intensive care unit patients with sepsis

Q: What are the key findings of this study?

A systemic inflammatory response index (SIRI) greater than 6.1 was significantly associated with an increased risk of poor prognosis in ICU patients with sepsis (OR 1.981).

Key Result

A systemic inflammatory response index (SIRI) greater than 6.1 was significantly associated with an increased risk of poor prognosis in ICU patients with sepsis (OR 1.981).

Study Design

Type

Observational (n=401)

Multicenter

Structured PICO

Does a higher systemic inflammatory response index (SIRI) predict worse prognosis in ICU patients with sepsis?

Population

401 adult patients admitted to the ICU with sepsis and a SOFA score of ≥ 2, evaluated for the prognostic value of the systemic inflammatory response index.

Exposure

Systemic inflammatory response index (SIRI) calculated from baseline blood samples upon ICU admission.

Comparator

Lower SIRI levels (analyzed continuously and by tertiles).

Outcome

Improvement or deterioration of the condition during the ICU stay (deterioration defined as mean arterial pressure <65 mmHg for >48h and forgoing treatment, or death within 28 days of ICU admission).hard clinical

Higher systemic inflammatory response index (SIRI) levels upon ICU admission are independently associated with increased disease severity and worse prognosis in patients with sepsis.

Main Result

Odds Ratio: 1.981 (95% CI 1.255–3.126)

p-value: p=<0.001

Limitations

Observational study design cannot establish causation.
Single-center study limits generalizability.
Potential unmeasured confounders may still exist despite adjustments.
Only admission parameters were collected, missing dynamic changes during hospitalization.

Abstract

Sepsis is a severe infectious disease with high mortality. However, the indicators used to evaluate its severity and prognosis are relatively complicated. The systemic inflammatory response index (SIRI), a new inflammatory indicator, has shown good predictive value in chronic infection, stroke, and cancer. The purpose of this study was to investigate the connection between sepsis and SIRI and evaluate its predictive usefulness. A total of 401 patients with sepsis were included in this study. Multiple linear regression and logistic regression analyses were performed to evaluate the relationship between SIRI and sepsis. The restricted cubic spline (RCS) method was employed to illustrate the dose-response relationship. The area under the curve (AUC) and decision curve analysis (DCA) were used to evaluate the prognostic value of SIRI. Multiple linear regression analysis revealed a significant positive correlation between SIRI and both blood cell count and Sequential Organ Failure Assessment (SOFA) score. Additionally, higher SIRI levels were significantly linked to a higher risk of sepsis worsening, according to logistic regression analysis. The RCS curve demonstrated that the risk of poor prognosis rose with increasing SIRI, particularly when SIRI exceeded 6.1. Furthermore, AUC and DCA results showed that SIRI had superior predictive value compared to traditional indicators. A higher SIRI is linked to a worse prognosis and more severe sepsis. SIRI may serve as a novel prognostic indicator in sepsis, though further clinical studies are necessary to confirm these findings.

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