Diagnostic Accuracy of Systemic Inflammatory Markers in Acute Pulmonary Embolism

Aim: Acute pulmonary embolism (APE) is one of the major causes of death globally. The condition results from the combined effects of coagulation disorders, vascular damage, and inflammation. Recently, hematological markers such as the systemic immune response index (SIRI), systemic immune-inflammation index (SII) and neutrophil/lymphocyte ratio (NLR) have been identified as potential predictors of worse clinical outcomes, but their role in APE diagnosis remains underexplored.We aimed to investigate the predictive value of these inflammatory biomarkers on APE diagnosis retrospectively.Materials and Methods: 284 adult patients with suspected APE who underwent computed tomography pulmonary angiography imaging at the Emergency Department were evaluated. Patients were divided into APE group and control group. The C-reactive protein, D-dimer levels, complete blood count Wells Score, SIRI, PLR, NLR and SII scores were evaluated.Results: The APE group included 53, and the control group included 231 participants. History of previous pulmonary embolism, dyspnea, chest pain, Wells score, D-dimer, and C-reactive protein levels white blood cell count, neutrophil count, NLR were significantly higher in the APE group. ROC analysis revealed that NLR, Wells Score, SII, SIRI, and D-dimer were found to have predictive value for APE diagnosis. Multivariate analysis showed Wells score as the only influencing factor for APE diagnosis.Conclusions: NLR, SII, and SIRI, combined with Wells Score and D-dimer levels, may improve the diagnostic accuracy of APE. Further prospective cohorts with larger population can determine the accuracy of these parameters on APE diagnosis.