Is it Possible to Predict High-Risk Patients in Acute Pulmonary Embolism with Systemic Immune-Inflammation Index?

Abstract

Background: Acute pulmonary embolism (APE) is a cardiovascular emergency that has a high morbidity and mortality probability. The aim of this study is to investigate the clinical value of the systemic immune inflammation index (SII) in predicting high-risk patients admitted to the emergency department with a diagnosis of Acute pulmonary embolism (APE). Materials and Methods: This clinical study, which was conducted according to a cross-sectional study design, included 193 patients diagnosed with APE who presented to the emergency department of a tertiary hospital. According to the guideline, patients with Pulmonary Embolism Severity Index (PESI) class III–V or sPESI ≥I were identified as high risk. ROC (Area Under the Curve) analysis was used to determine the cut-off in predicting high-risk APE. Results: In our research, 71 of the patients had high-risk APE. In detecting high-risk APE, SII was found to have excellent diagnostic power (AUC: 0.84), while neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and monocyte to lymphocyte (MLR) were found to have acceptable diagnostic power (AUC: 0.76-0.78), red cell distribution width (RDW) to lymphocyte (RLR) was of fair diagnostic power (AUC: 0.68). Conclusion: We have shown that SII can be a valuable and useful potential biomarker to identify high-risk patients in patients with APE. We also found that MLR and RLR are biomarkers that can be used to predict severe APE.