Systemic immune-inflammation index for predicting postoperative atrial fibrillation following cardiac surgery: a meta-analysis

被引:12
作者
Chen, Yu-Chou [1 ]
Liu, Chien-Cheng [2 ,3 ,4 ]
Hsu, Hui-Chen [5 ]
Hung, Kuo-Chuan [1 ]
Chang, Ying-Jen [1 ,6 ]
Ho, Chun-Ning [1 ]
Hsing, Chung-Hsi [1 ,7 ]
Yiu, Ching-Yi [8 ,9 ]
机构
[1] Chi Mei Med Ctr, Dept Anesthesiol, Tainan, Taiwan
[2] I Shou Univ, E Da Hosp, Dept Anesthesiol, Kaohsiung, Taiwan
[3] I Shou Univ, Coll Med, Dept Nursing, Kaohsiung, Taiwan
[4] I Shou Univ, Sch Med, Kaohsiung, Taiwan
[5] Kuang Tien Gen Hosp, Dept Otolaryngol, Taichung, Taiwan
[6] Chia Nan Univ Pharm & Sci, Dept Recreat & Hlth Care Management, Coll Recreat & Hlth Management, Tainan, Taiwan
[7] Chi Mei Med Ctr, Dept Med Res, Tainan, Taiwan
[8] Chi Mei Med Ctr, Dept Otolaryngol, Tainan, Taiwan
[9] Min Hwei Jr Coll Hlth Care Management, Dept Dent Lab Technol, Tainan, Taiwan
来源
FRONTIERS IN CARDIOVASCULAR MEDICINE | 2024年 / 11卷
关键词
postoperative atrial fibrillation; systemic immune-inflammation index; cardiac surgery; inflammation; cardiopulmonary bypass; LYMPHOCYTE RATIO; RISK; TERM;
D O I
10.3389/fcvm.2024.1290610
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Postoperative atrial fibrillation (POAF) is a frequent complication that may increase morbidity and mortality risk following cardiac surgery. The systemic immune-inflammation index (SII) is an emerging biomarker that provides an integrated measure of inflammation by incorporating neutrophil, lymphocyte, and platelet counts. Recent studies have reported associations between elevated SII and increased POAF risk; however, significant heterogeneity exists regarding its predictive efficacy. This meta-analysis aimed to assess SII's diagnostic efficacy for predicting POAF risk.Methods To synthesize existing evidence on the ability of perioperative SII for predicting POAF in patients undergoing cardiac surgery, a systematic review and meta-analysis was conducted. In August 2023, a comprehensive literature search was performed to identify relevant studies reporting SII cutoff values with corresponding sensitivity and specificity. The primary aim was to evaluate SII's diagnostic utility for predicting POAF, whereas secondary outcomes included the pooled incidence of POAF and the relationship between the SII and POAF.Results Eight studies published between 2021 and 2023 with 3,245 patients were included. Six studies involved coronary artery bypass grafting (CABG) surgery; one encompassed various cardiac procedures, and another focused solely on mitral valve surgery. The pooled incidence of POAF was 23.6% [95% confidence interval (CI), 18.7%-29.2%]. Elevated SII significantly increased the odds of POAF by 3.24-fold (odds ratio, 3.24; 95% CI, 1.6-6.55; p = 0.001). SII's pooled sensitivity and specificity for predicting POAF were 0.80 (95% CI, 0.68-0.89) and 0.53 (95% CI, 0.23-0.8), respectively. The SII had moderate predictive accuracy based on a hierarchical summary receiver operating characteristic (HSROC) area under the curve of 0.78 (95% CI, 0.74-0.81). Subgroup analyses, whether focusing on CABG alone or CABG with cardiopulmonary bypass (CPB), both indicated an area under the HSROC curve of 0.78 (95% CI, 0.74-0.81).Conclusion Elevated SII is significantly correlated with an increased POAF risk following cardiac surgery, highlighting its utility as a predictive biomarker. Considering its moderate diagnostic accuracy, further research is essential for clarifying SII's clinical effectiveness, either as an independent predictor or combined with other risk factors, for stratifying patients at high POAF risk.Systematic Review Registration https://www.crd.york.ac.uk/prospero/, identifier [CRD42023456128].
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页数:12
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