Evaluation of systemic immune-inflammation index (SII) in acute deep venous thrombosis: a propensity-matched analysis

Abstract

Deep vein thrombosis (DVT) progressing to pulmonary embolism is an important cause of mortality and morbidity worldwide. Today, color Doppler ultrasonography (CDUS) is the most effective method in the diagnosis of DVT examination method. The systemic immune-inflammatory index (SII) has been introduced as a new indicator of comprehensive systemic immune-thrombosis and inflammatory status in the body. We think that SII may be more specific and sensitive than NLR and PLR. In this study, it was aimed to evaluate the predictive potential of systemic immune-inflammatory index (SII), neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in the diagnosis of DVT.

Methods: The data of patients older than 18 years of age who were diagnosed with acute DVT in our hospital between June 2017 and June 2021 were retrospectively reviewed. Between these dates, the data of 155 patients with acute DVT and 179 healthy control patients without DVT were included in the study. Propensity score analysis (1:1) was performed on it to eliminate the difference between the groups. 63 patients from both groups were included in the study.

Results: When CBC parameters were examined between patients with acute DVT and the control group, Hemoglobin (Hg), Hematocrit (Htc), Lymphocyte (Lym) and Platelet Distribution Width (PDW) were lower in the DVT group. On the other hand, White Blood Cell (WBC), Neutrophil (Neu), Platelets (Plt), NLR, PLR, SII and Mean Platelet Volume (MPV) were found to be higher in the DVT group. The changes in Hg (p=0.001), Htc (p=0.001), WBC (p=0.001), Neu (p=0.001), Lym (p=0.001), Plt (p=0.001), NLR (p=0.001), PLR (p=0.001), SII (p=0.001) and MPV (p=0.031) were significant in the statistical analysis, but the changes in PDW (p=0.794) were not The AUCs for NLR, PLR were 0.797 (95% CI: 0.747-0.848, p < 0.001) and 0.788 (95% CI: 0.737-0.840, p=0.01), respectively. A sensitivity of 71.0% and a specificity of 68.7% were found for NLR >3.00. A sensitivity of 70.3% and a specificity of 68.5% were found for PLR >142.66. The AUC analysis result for SII was 0.861 (95% CI: 0.820-0.902, p < 0.001). A sensitivity of 78.1% and a specificity of 73.1% were found for SII >755.54.

Conclusions: In conclusion, systemic immune-inflammatory index can be used as an auxiliary diagnostic test in patients with venous thrombosis. This parameter is superior to NLR and PLR with its high sensitivity and specificity in venous thrombosis patients.