Effect of systemic immune-inflammatory index on postoperative pulmonary complications in patients undergoing abdominal surgery: a retrospective observational study_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Zaili , LI Xuefei , YU Hong , SUN Qirong ,  YU Hai

Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

YU Hai, Email: yuhaishan117@yahoo.com

Keywords：

systemic immune-inflammatory index; postoperative pulmonary complication; abdominal surgery; inflammatory marker

DOI：

10.7507/1007-9424.202101061

Video：

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Objective To determine the predictive value of preoperative systemic immune-inflammatory index (SII) regarding the development of postoperative pulmonary complications (PPCs) after abdominal surgery.Methods Thisretrospective study involved 433 patients undergoing elective abdominal surgery. Logistic regression risk model was used to evaluate the prognostic value of SII. We drew the receiver-operating characteristic (ROC) curve and calculated the area under the ROC curve to compared the predictive ability of SII, platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and monocyte-to- lymphocyte ratio (MLR).Results The independent risk factors of PPCs were preoperative respiratory diseases, preoperative history of chronic liver disease, maintenance of intravenous or inhalation anesthesia, and intraoperative infusion of more colloid (P<0.05). However, SII, PLR, NLR, and MLR did not predict the occurrence of PPCs, and they also did not predict ≥3 grade of PPCs (AUC<0.60, P>0.05).Conclusions Preoperative SII is not a prognostic biomarker of PPCs occurrence in patients undergoing elective abdominal surgery. Other biomarkers, such as PLR, NLR, and MLR, also have no predictive value for the PPCs in these patients.

Citation： WANG Zaili, LI Xuefei, YU Hong, SUN Qirong, YU Hai. Effect of systemic immune-inflammatory index on postoperative pulmonary complications in patients undergoing abdominal surgery: a retrospective observational study. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(5): 625-630. doi: 10.7507/1007-9424.202101061 Copy

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2.	Kanat F, Golcuk A, Teke T, et al. Risk factors for postoperative pulmonary complications in upper abdominal surgery. ANZ J Surg, 2007, 77(3): 135-141.
3.	O’Gara B, Talmor D. Perioperative lung protective ventilation. BMJ, 2018, 362: k3030.
4.	Perilli V, Aceto P, Ancona P, et al. Role of surgical setting and patients-related factors in predicting the occurrence of postoperative pulmonary complications after abdominal surgery. Eur Rev Med Pharmacol Sci, 2018, 22(2): 547-550.
5.	Wolthuis EK, Choi G, Dessing MC, et al. Mechanical ventilation with lower tidal volumes and positive end-expiratory pressure prevents pulmonary inflammation in patients without preexisting lung injury. Anesthesiology, 2008, 108(1): 46-54.
6.	Fu H, Zheng J, Cai J, et al. Systemic immune-inflammation index (SII) is useful to predict survival outcomes in patients after liver transplantation for hepatocellular carcinoma within Hangzhou criteria. Cell Physiol Biochem, 2018, 47(1): 293-301.
7.	Wang K, Diao F, Ye Z, et al. Prognostic value of systemic immune-inflammation index in patients with gastric cancer. Chin J Cancer, 2017, 36(1): 75.
8.	Trifan G, Testai FD. Systemic immune-inflammation (SII) index predicts poor outcome after spontaneous supratentorial intracerebral hemorrhage. J Stroke Cerebrovasc Dis, 2020, 29(9): 105057.
9.	Cuschieri S. The STROBE guidelines. Saudi J Anaesth, 2019, 13(Suppl 1): S31-S34.
10.	Ferrando C, Soro M, Unzueta C, et al. Individualised perioperative open-lung approach versus standard protective ventilation in abdominal surgery (iPROVE): a randomised controlled trial. Lancet Respir Med, 2018, 6(3): 193-203.
11.	Langeron O, Carreira S, le Saché F, et al. Postoperative pulmonary complications updating. Ann Fr Anesth Reanim, 2014, 33(7-8): 480-483.
12.	Zhang MQ, Liao YQ, Yu H, et al. Ventilation strategies with different inhaled oxygen concentration during cardiopulmonary bypass in cardiac surgery (VONTCPB): study protocol for a randomized controlled trial. Trials, 2019, 20(1): 254.
13.	Fernandez-Bustamante A, Frendl G, Sprung J, et al. Postoperative pulmonary complications, early mortality, and hospital stay following noncardiothoracic surgery: a multicenter study by the perioperative research network investigators. JAMA Surg, 2017, 152(2): 157-166.
14.	Ladha K, Vidal Melo MF, McLean DJ, et al. Intraoperative protective mechanical ventilation and risk of postoperative respiratory complications: hospital based registry study. BMJ, 2015, 351: h3646.
15.	Bagchi A, Rudolph MI, Ng PY, et al. The association of postoperative pulmonary complications in 109 360 patients with pressure-controlled or volume-controlled ventilation. Anaesthesia, 2017, 72(11): 1334-1343.
16.	Kim TH, Lee JS, Lee SW, et al. Pulmonary complications after abdominal surgery in patients with mild-to-moderate chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis, 2016, 11: 2785-2796.
17.	Canet J, Gallart L, Gomar C, et al. Prediction of postoperative pulmonary complications in a population-based surgical cohort. Anesthesiology, 2010, 113(6): 1338-1350.
18.	Zhang Y, Chen B, Wang L, et al. Systemic immune-inflammation index is a promising noninvasive marker to predict survival of lung cancer: A meta-analysis. Medicine (Baltimore), 2019, 98(3): e13788.
19.	Wang Y, Li Y, Chen P, et al. Prognostic value of the pretreatment systemic immune-inflammation index (SII) in patients with non-small cell lung cancer: a meta-analysis. Ann Transl Med, 2019, 7(18): 433.
20.	Chen JH, Zhai ET, Yuan YJ, et al. Systemic immune-inflammation index for predicting prognosis of colorectal cancer. World J Gastroenterol, 2017, 23(34): 6261-6272.
21.	Jomrich G, Paireder M, Kristo I, et al. High systemic immune-inflammation index is an adverse prognostic factor for patients with gastroesophageal adenocarcinoma. Ann Surg, 2021, 273(3): 532-541.
22.	Murthy P, Zenati MS, Al Abbas AI, et al. Prognostic value of the systemic immune-inflammation index (SII) after neoadjuvant therapy for patients with resected pancreatic cancer. Ann Surg Oncol, 2020, 27(3): 898-906.
23.	Albany C. Systemic immune-inflammation index in germ-cell tumours: search for a biological prognostic biomarker. Br J Cancer, 2018, 118(6): 761-762.
24.	Chovanec M, Cierna Z, Miskovska V, et al. Systemic immune-inflammation index in germ-cell tumours. Br J Cancer, 2018, 118(6): 831-838.
25.	Zhang W, Wang R, Ma W, et al. Systemic immune-inflammation index predicts prognosis of bladder cancer patients after radical cystectomy. Ann Transl Med, 2019, 7(18): 431.
26.	Li S, Liu K, Gao Y, et al. Prognostic value of systemic immune-inflammation index in acute/subacute patients with cerebral venous sinus thrombosis. Stroke Vasc Neurol, 2020, 5(4): 368-373.
27.	Kim JW, Jung JY, Suh CH, et al. Systemic immune-inflammation index combined with ferritin can serve as a reliable assessment score for adult-onset Still’s disease. Clin Rheumatol, 2021, 40(2): 661-668.

1. Futier E, Constantin JM, Paugam-Burtz C, et al. A trial of intraoperative low-tidal-volume ventilation in abdominal surgery. N Engl J Med, 2013, 369(5): 428-437.
2. Kanat F, Golcuk A, Teke T, et al. Risk factors for postoperative pulmonary complications in upper abdominal surgery. ANZ J Surg, 2007, 77(3): 135-141.
3. O’Gara B, Talmor D. Perioperative lung protective ventilation. BMJ, 2018, 362: k3030.
4. Perilli V, Aceto P, Ancona P, et al. Role of surgical setting and patients-related factors in predicting the occurrence of postoperative pulmonary complications after abdominal surgery. Eur Rev Med Pharmacol Sci, 2018, 22(2): 547-550.
5. Wolthuis EK, Choi G, Dessing MC, et al. Mechanical ventilation with lower tidal volumes and positive end-expiratory pressure prevents pulmonary inflammation in patients without preexisting lung injury. Anesthesiology, 2008, 108(1): 46-54.
6. Fu H, Zheng J, Cai J, et al. Systemic immune-inflammation index (SII) is useful to predict survival outcomes in patients after liver transplantation for hepatocellular carcinoma within Hangzhou criteria. Cell Physiol Biochem, 2018, 47(1): 293-301.
7. Wang K, Diao F, Ye Z, et al. Prognostic value of systemic immune-inflammation index in patients with gastric cancer. Chin J Cancer, 2017, 36(1): 75.
8. Trifan G, Testai FD. Systemic immune-inflammation (SII) index predicts poor outcome after spontaneous supratentorial intracerebral hemorrhage. J Stroke Cerebrovasc Dis, 2020, 29(9): 105057.
9. Cuschieri S. The STROBE guidelines. Saudi J Anaesth, 2019, 13(Suppl 1): S31-S34.
10. Ferrando C, Soro M, Unzueta C, et al. Individualised perioperative open-lung approach versus standard protective ventilation in abdominal surgery (iPROVE): a randomised controlled trial. Lancet Respir Med, 2018, 6(3): 193-203.
11. Langeron O, Carreira S, le Saché F, et al. Postoperative pulmonary complications updating. Ann Fr Anesth Reanim, 2014, 33(7-8): 480-483.
12. Zhang MQ, Liao YQ, Yu H, et al. Ventilation strategies with different inhaled oxygen concentration during cardiopulmonary bypass in cardiac surgery (VONTCPB): study protocol for a randomized controlled trial. Trials, 2019, 20(1): 254.
13. Fernandez-Bustamante A, Frendl G, Sprung J, et al. Postoperative pulmonary complications, early mortality, and hospital stay following noncardiothoracic surgery: a multicenter study by the perioperative research network investigators. JAMA Surg, 2017, 152(2): 157-166.
14. Ladha K, Vidal Melo MF, McLean DJ, et al. Intraoperative protective mechanical ventilation and risk of postoperative respiratory complications: hospital based registry study. BMJ, 2015, 351: h3646.
15. Bagchi A, Rudolph MI, Ng PY, et al. The association of postoperative pulmonary complications in 109 360 patients with pressure-controlled or volume-controlled ventilation. Anaesthesia, 2017, 72(11): 1334-1343.
16. Kim TH, Lee JS, Lee SW, et al. Pulmonary complications after abdominal surgery in patients with mild-to-moderate chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis, 2016, 11: 2785-2796.
17. Canet J, Gallart L, Gomar C, et al. Prediction of postoperative pulmonary complications in a population-based surgical cohort. Anesthesiology, 2010, 113(6): 1338-1350.
18. Zhang Y, Chen B, Wang L, et al. Systemic immune-inflammation index is a promising noninvasive marker to predict survival of lung cancer: A meta-analysis. Medicine (Baltimore), 2019, 98(3): e13788.
19. Wang Y, Li Y, Chen P, et al. Prognostic value of the pretreatment systemic immune-inflammation index (SII) in patients with non-small cell lung cancer: a meta-analysis. Ann Transl Med, 2019, 7(18): 433.
20. Chen JH, Zhai ET, Yuan YJ, et al. Systemic immune-inflammation index for predicting prognosis of colorectal cancer. World J Gastroenterol, 2017, 23(34): 6261-6272.
21. Jomrich G, Paireder M, Kristo I, et al. High systemic immune-inflammation index is an adverse prognostic factor for patients with gastroesophageal adenocarcinoma. Ann Surg, 2021, 273(3): 532-541.
22. Murthy P, Zenati MS, Al Abbas AI, et al. Prognostic value of the systemic immune-inflammation index (SII) after neoadjuvant therapy for patients with resected pancreatic cancer. Ann Surg Oncol, 2020, 27(3): 898-906.
23. Albany C. Systemic immune-inflammation index in germ-cell tumours: search for a biological prognostic biomarker. Br J Cancer, 2018, 118(6): 761-762.
24. Chovanec M, Cierna Z, Miskovska V, et al. Systemic immune-inflammation index in germ-cell tumours. Br J Cancer, 2018, 118(6): 831-838.
25. Zhang W, Wang R, Ma W, et al. Systemic immune-inflammation index predicts prognosis of bladder cancer patients after radical cystectomy. Ann Transl Med, 2019, 7(18): 431.
26. Li S, Liu K, Gao Y, et al. Prognostic value of systemic immune-inflammation index in acute/subacute patients with cerebral venous sinus thrombosis. Stroke Vasc Neurol, 2020, 5(4): 368-373.
27. Kim JW, Jung JY, Suh CH, et al. Systemic immune-inflammation index combined with ferritin can serve as a reliable assessment score for adult-onset Still’s disease. Clin Rheumatol, 2021, 40(2): 661-668.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effect of systemic immune-inflammatory index on postoperative pulmonary complications in patients undergoing abdominal surgery: a retrospective observational study

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