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. 2025 Jul 30:18:10181-10192.
doi: 10.2147/JIR.S531272. eCollection 2025.

The Clinical Value of Systemic Immune Inflammatory Index in Predicting the Prognosis of Patients with Bloodstream Infection

Shuheng Ou #  1 , Hong Lu #  2 , Rui Qu  3 , Xiaolong Cui  3 , Zhou Xiong  4 , Fangfang Fan  5 , Xiao Yu  5 , Chaolu Hasi  2
Affiliations

The Clinical Value of Systemic Immune Inflammatory Index in Predicting the Prognosis of Patients with Bloodstream Infection

Shuheng Ou et al. J Inflamm Res. .

Abstract

Introduction: We analyzed the correlation between systemic immune inflammatory index (SII), systemic inflammatory response index (SIRI), systemic inflammatory index (AISI), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR) and mortality in patients with bloodstream infection to determine their application potential in predicting the prognosis of bloodstream infection.

Methods: We calculated SII, SIRI, AISI, NLR, PLR, and MLR in 469 patients with bloodstream infections. Logistic regression modeling, generalized additive modeling (GAM), and smoothed curve fitting were used to investigate the correlation of SII and other inflammatory markers with mortality in patients with bloodstream infections. Area under the curve (AUC) of ROC was used to assess the predictive effect of SII and other inflammatory markers.

Results: Levels of SII, SIRI, AISI, NLR, PLR, and MLR were significantly higher in the mortality group of this study (P < 0.05). There were significant differences in gender, age, diabetes, cardiovascular disease, respiratory disease, NEUT and LUMPH between the survival group and the death group (p < 0.05). Smooth curve fitting and GAM showed that SII and NLR had a non-linear relationship with death. After adjustment, the breakpoints (K) were 1711 and 7.22, respectively (P < 0.05), and there was a positive correlation on both sides of the breakpoint. The comparison of AUC values showed that SII and NLR had higher accuracy in predicting the risk of death in patients with bloodstream infection.

Conclusion: Studies demonstrates that SII and NLR are more predictive of mortality risk in patients with bloodstream infections. Patients with diabetes, cardiovascular disease, or respiratory disease should be monitored regularly for SII and NLR indicators to reduce the risk of death.

Keywords: bloodstream infection; neutrophil-to-lymphocyte ratio; prognosis; smooth curve fitting; systemic immune inflammatory index.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart.
Figure 2
Figure 2
Smooth curve fitting for SII, SIRI, AISI NLR, PLR and MLR with Survivor.
Figure 3
Figure 3
ROC curves and the AUC values of SII, SIRI, AISI, NLR, PLR and MLR.
See this image and copyright information in PMC

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