Diagnostic possibilities of composite inflammatory indexes in purulent-septic surgical diseases
https://doi.org/10.24884/2078-5658-2026-23-1-23-30
Abstract
Introduction. The emergence of new composite (incorporated, combined, aggregated) indices that allow simultaneously evaluating inflammation, nutrition, and immunity is being actively studied as a risk factor for severe cardiovascular, oncological, and infectious diseases.
The objective was to evaluate to evaluate the diagnostic capabilities of new composite inflammatory indices in the intensive care of severe acute pancreatitis and purulent-inflammatory diseases.
Materials and methods. The retrospective cohort study included 62 patients (male – 32, female – 30, median age – 49.5 years, Q1–Q3 – 35.5–64) in the intensive care unit with a diagnosis of severe acute pancreatitis, purulent-inflammatory. The significance of the following indicators reflecting the state of systemic inflammation, immunity, and nutrition were studied in surviving and deceased patients: NLR index (neutrophil/lymphocyte ratio); MLR index (monocyte/lymphocyte ratio); PLR index (platelet/lymphocyte ratio); LMR index (lymphocyte-monocyte ratio); NLPR index (neutrophil / lymphocyte x platelet ratio); AISI (aggregate index of systemic inflammation ); SIRI (systemic inflammatory response index); SII index (systemic immune-inflammation index); LCR index (lymphocyte/C-Reactive Protein ratio); CLR index (C-Reactive Protein/Lymphocyte Ratio); CALLY index (C reactive protein-albumin-lymphocyte index); TIH (total index hematology); CAR index (C-Reactive Protein/Albumin ratio); PNI (prognostic nutritional index); MII-1 ((multi inflammatory index) (Sysmex XT-2000i analyzers (Japan) and DxC 700 AU Beckman Coulter, USA)).
Results. Values of NLR > 3.8; PLR < 149; SIRI > 3.06; NLPR > 1.83; LCR < 120; CLR > 77.7; CAR > 2.51; CALLY index < 47; TIG < 12.8; PNI < 37; MII-1 > 334 are associated with the manifestation of systemic inflammation and the development of a critical condition in purulent-septic diseases.
Conclusion. The obtained cut-off points make it possible to use composite indexes for objectification and automatic calculation of the results and dynamics of intensive therapy for purulent-inflammatory diseases.
About the Author
Yu. Yu. Kiryachkov
Grodno State Medical University
Belarus
Belarus
Kiryachkov Yurij Yu., Dr. of Sci. (Med.), Professor of the Department of Anesthesiology and Intensive Care, Professor of the Grodno University Clinic
80, Gor`kogo str., Grodno, 230009
References
1. Balta O., Astan S., Altınayak H. et al. Can C-reactive protein-lymphocyte ratio be used as a screening tool to confirm the diagnosis of periprosthetic joint infection? // Clin Orthop Surg. – 2023. – Vol. 15, № 6. – Р. 917–927. http://doi.org/10.4055/cios22313.
2. Chen X., Guo W., Diao Z. et al. Lymphocyte-to-C reactive protein ratio as novel inflammatory marker for predicting outcomes in hemodialysis patients: A multicenter observational study // Front Immunol. – 2023. – Vol. 2, № 14. – Р. 1101222. http://doi.org/10.3389/fimmu.2023.1101222.
3. Demirel M. E., Akunal Turel C. The role of the multi-inflammatory index as a novel predictor of hospital mortality in acute ischemic stroke // Cureus. – 2023. – Vol. 15, № 8. – Р. e43258. http://doi.org/10.7759/cureus.43258.
4. Ginesu G. C., Paliogiannis P., Feo C. F. et al. Inflammatory indexes as predictive biomarkers of postoperative complications in oncological thoracic surgery // Curr Oncol. – 2022. – Vol. 29, № 5. – Р. 3425–3432. http://doi.org/10.3390/curroncol29050276.
5. Heidarpour M., Bashiri S., Vakhshoori M. et al. The association between platelet-to-lymphocyte ratio with mortality among patients suffering from acute decompensated heart failure // BMC Cardiovasc Disord. – 2021. – Vol. 21, № 1. – Р. 454. http://doi.org/10.1186/s12872-021-02260-7.
6. Huang Y., Zhang Q., Li P. et al. The prognostic nutritional index predicts all-cause mortality in critically ill patients with acute myocardial infarction // BMC Cardiovasc Disord. – 2023. – Vol. 23, № 1. – Р. 339. http://doi.org/10.1186/s12872-023-03350-4.
7. Huang Y. H., Zhang Y., Li Z. P. et al. Association between a four-parameter inflammatory index and all-cause mortality in critical ill patients with non-traumatic subarachnoid hemorrhage: a retrospective analysis of the MIMIC-IV database (2012-2019) // Front Immunol. – 2023. Vol. 23, № 14. – Р. 1235266. http://doi.org/10.3389/fimmu.2023.1235266.
8. Iida H., Tani M., Komeda K. et al. Superiority of CRP-albumin-lymphocyte index (CALLY index) as a non-invasive prognostic biomarker after hepatectomy for hepatocellular carcinoma // HPB (Oxford). – 2022. – Vol. 24, № 1. – Р. 101–115. http://doi.org/10.1016/j.hpb.2021.06.414.
9. Jiang D., Bian T., Shen Y. et al. Association between admission systemic immune-inflammation index and mortality in critically ill patients with sepsis: a retrospective cohort study based on MIMIC-IV database // Clin Exp Med. – 2023. – Vol. 23, № 7. – Р. 3641–3650. http://doi.org/10.1007/s10238-023-01029-w.
10. Ljungstrom L. Diagnostic accuracy of procalcitonin, neutrophil- lymphocyte count ratio, C-reactive protein, and lactate in patients with suspected bacterial sepsis // PLoS One. – 2017. – Vol. 12, № 7. – P. e0181704. http://doi.org/10.1371/journal.pone.0181704/
11. Li F., He Q., Peng H. et al. The systemic inflammation indexes after admission predict in-hospital mortality in patients with extensive burns // Burns. – 2024. – Vol. 50, № 4. – P. 980–990. http://doi.org/10.1016/j.burns.2024.01.020.
12. Li Y., Zou Z., Zhang Y. et al. Dynamics in perioperative neutrophil-to-lymphocyte*platelet ratio as a predictor of early acute kidney injury following cardiovascular surgery // Ren Fail. – 2021. – Vol. 43, № 1. – P. 1012–1019. http://doi.org/10.1080/0886022X.2021.1937220.
13. Li X., Chen Y., Yuan Q. et al. Neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio associated with 28-day all-cause mortality in septic patients with coronary artery disease: a retrospective analysis of MIMIC-IV database // BMC Infect Dis. – 2024. – Vol. 29, № 24. – Р. 749. http://doi.org/10.1186/s12879-024-09516-5.
14. Ma F., Li L., Xu L. et al. The relationship between systemic inflammation index, systemic immune-inflammatory index, and inflammatory prognostic index and 90-day outcomes in acute ischemic stroke patients treated with intravenous thrombolysis // J Neuroinflammation. – 2023. – Vol. 20, № 1. – Р. 220. http://doi.org/10.1186/s12974-023-02890-y.
15. Menyar A., Mekkodathil A., Al-Ansari A. et al. Platelet-lymphocyte and neutrophil-lymphocyte ratio for prediction of hospital outcomes in patients with abdominal trauma // Biomed Res Int. – 2022. – Vol. 7. – P. 5374419. http://doi.org/10.1155/2022/5374419.
16. Oh A. R., Park J., Lee J. H. et al. Association between inflammation-based prognostic markers and mortality of non-cardiac surgery // Korean J Anesthesiol. – 2023. – Vol. 76, № 6. – Р. 550–558. http://doi.org/10.4097/kja.23068.
17. Paliogiannis P., Ginesu G. C., Tanda C. et al. Inflammatory cell indexes as preoperative predictors of hospital stay in open elective thoracic surgery // ANZ J Surg. – 2018. – Vol. 88, № 6. – Р. 616–620. http://doi.org/10.1111/ans.14557.
18. Şahan T. D., Karakaya Z., Bora E. S. et al. Inflammatory indexes in emergency patients with hypertensive pulmonary Oedema: A critical insight // Am J Emerg Med. – 2025. – Vol. 2, № 91. – Р. 93–99. http://doi.org/10.1016/j.ajem.2025.02.025.
19. Sant’Ana M., Gameiro J., Costa C. et al. C-reactive protein-to-albumin ratio and six-month mortality in incident hemodialysis patients // Ren Fail. – 2023. – Vol. 45, № 1. – Р. 2182615. http://doi.org/10.1080/0886022X.2023.2182615.
20. Schietroma M., Romano L., Schiavi D. et al. Systemic inflammation response index (SIRI) as predictor of anastomotic leakage after total gastrectomy for gastric cancer // Surg Oncol. – 2022. – Vol. 43. – P. 101791. http://doi.org/10.1016/j.suronc.2022.101791.
21. Tsunematsu M., Haruki K., Taniai T. et al. The impact of C-reactive protein-albumin-lymphocyte (CALLY) index on the prognosis of patients with distal cholangiocarcinoma following pancreaticoduodenectomy // Ann Gastroenterol Surg. – 2022. – Vol. 7, № 3. – Р. 503–511. http://doi.org/10.1002/ags3.12637.
22. Wang R. H., Wen W. X., Jiang Z. P. et al. The clinical value of neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), platelet-to-lymphocyte ratio (PLR) and systemic inflammation response index (SIRI) for predicting the occurrence and severity of pneumonia in patients with intracerebral hemorrhage // Front Immunol. – 2023. – Vol. 13, № 14. – Р. 1115031. http://doi.org/10.3389/fimmu.2023.1115031.
23. Xu X. Y., Gao Y., Yue C. S. et al. Predictive and prognostic potentials of lymphocyte-C-reactive protein ratio upon hospitalization in adult patients with acute pancreatitis // J Inflamm. Res. – 2024. – Vol. 13, № 17. – Р. 1659–1669. http://doi.org/10.2147/JIR.S450587.
24. Yang Y., Xu Y., Lu P. et al. The prognostic value of monocyte-to-lymphocyte ratio in peritoneal dialysis patients // Eur J Med Res. – 2023. – Vol. 28, № 1. – Р. 152. http://doi.org/10.1186/s40001-023-01073-y.
25. Yao W., Wang W., Tang W. et al. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune inflammation index (SII) to predict postoperative pneumonia in elderly hip fracture patients // J Orthop Surg Res. – 2023. – Vol. 18, № 1. – P. 673. http://doi.org/10.1186/s13018-023-04157-x.
26. Zahorec R. Ratio of neutrophil to lymphocyte counts--rapid and simple parameter of systemic inflammation and stress in critically ill // Bratisl Lek Listy. – 2001. – Vol. 102, № 1. – P. 5–14.
27. Zhang Z., Hu Q., Hu T. Association of lymphocyte to monocyte ratio and risk of in-hospital mortality in patients with cardiogenic shock: a propensity score matching study // Int J Gen Med. – 2021. – Vol. 12, № 14. – Р. 4459–4468. http://doi.org/10.2147/IJGM.S325907.
Review
For citations:
Kiryachkov Yu.Yu. Diagnostic possibilities of composite inflammatory indexes in purulent-septic surgical diseases. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2026;23(1):23-30. (In Russ.) https://doi.org/10.24884/2078-5658-2026-23-1-23-30
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