全身免疫炎症指数预测合并实体恶性肿瘤ICU患者的临床结局——一项倾向评分匹配研究

System immune-inflammation index predicts prognosis of patients with solid tumor in ICU:a propensity score-matched analysis

目的探讨全身免疫炎症指数(SII)对入住ICU中合并实体恶性肿瘤患者180 d死亡率的预测作用。方法收集来自MIMIC-III数据库中1377例符合纳入标准的ICU患者,应用ROC曲线确定SII最佳临床分界值,依次分为高SII组和低SII组,并且使用倾向评分匹配平衡两组基线特征,采用Kaplan-Meier法绘制两组患者的生存曲线,并通过构建Cox比例风险回归模型进行单因素和多因素分析。结果SII是合并实体恶性肿瘤ICU患者预后的危险因素(HR=2.311,95%CI:1.842~2.900,P<0.01),高SII组患者的180 d死亡率更高,预后更差。结论SII可以用来预测合并实体恶性肿瘤ICU患者的临床结局,具有简便、非侵袭性、经济的特点。

Objective To evaluate the application of system immune-inflammation index(SII)at admission in predicating the 180-day mortality in ICU patients with solid tumor.Methods A total of 1377 ICU patients with solid tumor from the Medical Information Mart for Intensive Care III(MIMIC-III)database were analyzed.The optimal SII cut-off value was identified using ROC curve,and the patients were classified as high SII group and low SII group.Propensity score-matched analysis was performed to balance baseline characteristics between two groups.Survival curves were plotted using the Kaplan-Meier method.Univariate and multivariate analyses were performed by the Cox proportional hazards regression model.Results SII was a risk factor for patients with solid tumor in ICU(HR=2.311,95%CI:1.842-2.900,P<0.01).Patients with high SII were associated with a higher 180-day mortality risk and poorer prognosis.Conclusion SII can be used as a good predictor for prognosis of patients with solid tumor in ICU.