Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jun 11;24(1):277.
doi: 10.1186/s12890-024-03086-7.

Predictive significance of systemic immune-inflammation index combined with prealbumin for postoperative pneumonia following lung resection surgery

Haihang Miao #  1 , Dingying Ge #  1 , Qianwen Wang  1 , Lulu Zhou  2 , Hongsheng Chen #  3 , Yibin Qin #  4 , Faqiang Zhang #  5
Affiliations

Predictive significance of systemic immune-inflammation index combined with prealbumin for postoperative pneumonia following lung resection surgery

Haihang Miao et al. BMC Pulm Med. .

Abstract

Background: We aimed to determine whether systemic immune-inflammation index (SII) combined with prealbumin can provide better predictive power for postoperative pneumonia in patients undergoing lung resection surgery.

Methods: We identified eligible patients undergoing lung resection surgery at the Affiliated Hospital of Nantong University from March 2021 to March 2022. Demographic characteristics, clinical data, and laboratory information were collected and reviewed from the electronic medical records of the patients. To test the effect of the combined detection of SII and prealbumin, we made an equation using logistic regression analysis. The receiver operating characteristic curve (ROC) was plotted to evaluate the predictive powers, sensitivity, and specificity of prealbumin, SII, and SII combined with prealbumin. Decision curve analysis (DCA) was used to determine the clinical validity and net benefit of different methods of detection.

Results: Totally 386 eligible patients were included with a median age of 62.0 years (IQR: 55.0, 68.0), and 57 (14.8%) patients presented with postoperative pneumonia within 7 days after surgery. The multivariate regression analysis showed that preoperative SII as continuous variable was associated with an increased risk of postoperative pneumonia (OR: 1.38, 95% CI: 1.19-2.83, P = 0.011), whereas the prealbumin as continuous variable remained as an independent protective predictor of postoperative pneumonia in the adjusted analysis (OR: 0.80, 95% CI: 0.37-0.89, P = 0.023). Compared to SII or prealbumin, the combined detection of preoperative SII and prealbumin showed a higher predictive power with area under curve of 0.79 (95% CI: 0.71-0.86, P < 0.05 for all). Additionally, DCA indicated that the combined detection was superior over preoperative SII or prealbumin alone in clinical validity and net benefit.

Conclusion: Both preoperative SII and prealbumin are independent influencing factors for postoperative pneumonia after lung resection surgery. The combined detection of preoperative SII and prealbumin can significantly improve prediction capability to identify potential postoperative pneumonia-susceptible patients, facilitating early interventions to improve postoperative quality of life for surgical lung resection patients.

Keywords: Lung resection surgery; Postoperative pneumonia; Prealbumin; Systemic immune-inflammation index (SII).

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no conflicts of interest exist.

Figures

Fig. 1
Fig. 1
Flow chart
Fig. 2
Fig. 2
Multivariate adjusted odds ratio for postoperative pneumonia is based on restricted cubic spline analysis with three knots at the 25th, 75th percentiles, and the reference point at the median of combined detection of SII and prealbumin. Solid lines indicate point estimates on the relationship between combined detection and postoperative pneumonia, and the dashed lines represent 95% CI estimation. OR, odds ratio; SII, systemic immune-inflammation index
Fig. 3
Fig. 3
ROC curve for postoperative pneumonia. ROC, receiver operating characteristic curve; SII, systemic immune-inflammation index
Fig. 4
Fig. 4
DCA for postoperative pneumonia. DCA, decision curve analysis; SII, systemic immune-inflammation index
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Ferrando C, Carramiñana A, Piñeiro P, Mirabella L, Spadaro S, Librero J, Ramasco F, Scaramuzzo G, Cervantes O, Garutti I, et al. Individualised, perioperative open-lung ventilation strategy during one-lung ventilation (iPROVE-OLV): a multicentre, randomised, controlled clinical trial. Lancet Respir Med. 2024;12(3):195–206. doi: 10.1016/S2213-2600(23)00346-6. - DOI - PubMed
    1. Boisen ML, Fernando RJ, Kolarczyk L, Teeter E, Schisler T, La Colla L, Melnyk V, Robles C, Rao VK, Gelzinis TA. The year in thoracic anesthesia: selected highlights from 2020. J Cardiothorac Vasc Anesth. 2021;35(10):2855–68. doi: 10.1053/j.jvca.2021.04.012. - DOI - PubMed
    1. Boisen ML, Fernando RJ, Alfaras-Melainis K, Hoffmann PJ, Kolarczyk LM, Teeter E, Schisler T, Ritchie PJ, La Colla L, Rao VK, et al. The year in thoracic anesthesia: selected highlights from 2021. J Cardiothorac Vasc Anesth. 2022;36(12):4252–65. doi: 10.1053/j.jvca.2022.08.007. - DOI - PubMed
    1. Alfaras-Melainis K, Fernando RJ, Boisen ML, Hoffman PJ, Rosenkrans DJ, Teeter E, Cardi AI, Laney J, Reagan A, Rao VK, et al. The year in thoracic anesthesia: selected highlights from 2022. J Cardiothorac Vasc Anesth. 2024;38(1):29–56. doi: 10.1053/j.jvca.2023.09.006. - DOI - PubMed
    1. Yang T, Velagapudi R, Terrando N. Neuroinflammation after surgery: from mechanisms to therapeutic targets. Nat Immunol. 2020;21(11):1319–26. doi: 10.1038/s41590-020-00812-1. - DOI - PMC - PubMed