Key result
Elevated systemic immune-inflammation index linked to ~74% higher LEDVT risk in hospitalized patients.
Why the study?
The systemic immune-inflammation index has garnered interest in cardiovascular disease, but its relationship with the risk of lower extremity deep venous thrombosis remains unclear.
Does an elevated systemic immune-inflammation index (SII) increase the risk of lower extremity deep venous thrombosis in hospitalized patients?
Observational (n=16,725)
No
Does an elevated systemic immune-inflammation index (SII) increase the risk of lower extremity deep venous thrombosis in hospitalized patients?
Odds Ratio: 1.74 (95% CI 1.546–1.959)
p-value: p=<0.001
Elevated systemic immune-inflammation index is significantly associated with an increased risk of lower extremity deep venous thrombosis in hospitalized patients, exhibiting a non-linear threshold effect.
Elevated SII was associated with higher LEDVT risk in hospitalized patients; hypothesis-generating and requires prospective validation before clinical adoption.
Background The systemic immune-inflammation index (SII), as a novel inflammatory biomarker, has recently attracted attention in cardiovascular disease research. However, the relationship between SII and risk of lower extremity deep venous thrombosis (LEDVT) remains unclear to date. Thus, this study aimed to explore the association in a large sample over a 10-year period (2012–2022). Methods All hospitalized patients undergoing lower extremity compression ultrasonography (CUS) examination were consecutively screened by searching our hospital information system database. The receiver operating characteristic (ROC) curve analysis was used to identify the optimal cut-off value for high and low SII group. Multivariate logistic regression analyses were performed to investigate the relationship between SII and LEDVT risk. Propensity score matching (PSM), subgroup and sensitivity analyses were also conducted. Moreover, restricted cubic spline (RCS) regression and two-piecewise linear regression models were used to assess the dose-response relationship between natural log transformed SII [ln(SII)] and risk of LEDVT. Results A total of 16,725 consecutive hospitalized patients were included, and 1,962 LEDVT events occurred. After adjusting for confounding factors, patients in the high SII group (≥ 574.2 × 10 9 /L) showed a 1.740-fold risk of LEDVT (95% CI : 1.546–1.959, P < 0.001), and elevated ln(SII) was associated with a 36.1% increased risk of LEDVT (95% CI : 1.278–1.449, P < 0.001). PSM, subgroup and sensitivity analyses confirmed the robustness of the association. A non-linear relationship was observed ( P non−linear < 0.001), with a threshold value of 5.6 × 10 9 /L for all LEDVT events. Above the threshold, each unit increase in ln(SII) had a 1.369-fold higher risk of LEDVT (95% CI : 1.271–1.475, P < 0.001). The association also existed in both distal and proximal LEDVT. Conclusion Elevated SII is significantly associated with an increased risk of LEDVT in hospitalized patients. Additionally, the association is non-linear and exhibit a threshold effect.
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Chen et al. (2023) conducted an observational in Lower extremity deep venous thrombosis (n=16,725). Systemic immune-inflammation index (SII) vs. Low SII (< 574.2 × 10^9/L) was evaluated on Occurrence of all lower extremity deep venous thrombosis (LEDVT) events during hospitalization (OR 1.740, 95% CI 1.546-1.959, p=<0.001). An elevated systemic immune-inflammation index (≥574.2 × 10^9/L) was significantly associated with an increased risk of lower extremity deep venous thrombosis in hospitalized patients (OR 1.740).
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