Relationship between Systemic Immune-inflammation Index and Mortality in Intensive Care Patients Diagnosed with Crimean-Congo Hemorrhagic Fever

Abstract

Objective: To evaluate the power of the systemic immune-inflammation index in the prediction of mortality in severe Crimean-Congo hemorrhagic fever patients. Study Design: Observational study. Place and Duration of Study: Department of Anaesthesiology and Reanimation, Sivas Cumhuriyet University, Sivas, Turkey, from January to June 2022. Methodology: Intensive care patients diagnosed with Crimean-Congo hemorrhagic fever, between January 2012 and January 2022, were included. Demographic data, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and systemic immune-inflammation index were recorded. Receiver operating characteristic analysis, Cox regression analysis and Kaplan-Meier mortality analyses were done. Results: A cut-off value <1.85 for neutrophil to lymphocyte ratio showed 41.67% sensitivity and 97.06% specificity. A cut-off value <80.75 for the systemic immune-inflammation index showed 84.72% sensitivity and 76.47% specificity. A cut-off value <37.86 for platelet-to- lymphocyte ratio showed 84.72% sensitivity and 73.53% specificity. In patients with systemic immune-inflammation index value <80.75, the mortality rate increased 2.549 times and 3.732 times in patients with a platelet-to-lymphocyte ratio value <37.86. Conclusion: Similar sensitivity and specificity levels were found for systemic immune-inflammation index and platel-to-lymphocyte ratio regarding the mortality prediction power and impact on mortality. Both tests can be used for the prediction of mortality during the hemorrhagic period in patients with severe Crimean-Congo Hemorrhagic Fever.