Systemic Immune-Inflammation Index (SII) Can Be an Early Indicator for Predicting the Severity of Acute Pancreatitis: A Retrospective Study

Figures & data

Table 1 Demographical Characteristics and Clinical Data of the Patients

Variables	MAP (n = 73)	SAP (MSAP and SAP) (n = 28)	P-value
Demographics
Age (y)	52 (38~66.5)	55.5 (39.25~66)	0.832
Gender (male%)	46 (63%)	11 (39.3%)	0.031*
Etiology of AP (n%)
Billary	36 (49.3%)	16 (57.1%)	0.481
Alcoholic	5 (6.8%)	2 (7.1%)	0.959
Hypertriglyceridemic	22 (30.1%)	7 (25%)	0.609
Others	10 (13.7%)	3 (10.7%)	0.688
ICU admission (admission%)	0 (0%)	11 (39.3%)	<0.001*
Inpatient days	7 (6~8)	12.5 (8~18.75)	<0.001*
Laboratory test
Urea	5.2 (4.4~6.05)	5.75 (4.35~7.2)	0.125
Creatinine	64 (50.97~79.45)	59.05 (51.18~80.3)	0.485
AST	29.1 (21.45~41.95)	45.25 (26.15~107.22)	0.020*
ALT	29.3 (21.8~53.5)	33.7 (19.28~102.65)	0.471
TB	14.9 (10.55~21.35)	16.5 (11.9~33.77)	0.265
GGT	49.3 (26.73~112.05)	67.4 (33.35~197.37)	0.173
ALP	83.3 (65.9~99.45)	101.9 (69.15~121.2)	0.041*
Amylase	274.7 (160.95~683.65)	441.15 (191.67~1163.3)	0.223
Lipase	1830.1 (745.15~7752.6)	4720.5 (925.85~9347.27)	0.173
WBC	10.92±403	14.35±4.35	<0.001*
Platelet	216 (165.5~254)	251.5 (198.25~315.5)	0.023*
Neutrophil	8.41±3.77	12.46±4.06	<0.001*
Monocyte	0.49 (0.37~0.62)	0.51 (0.35~1.17)	0.275
Lymphocyte	1.44 (1.10~2.37)	0.78 (0.41~0.97)	<0.001*
PLR	144.02 (98.19~175.18)	291.45 (205.07~603.90)	<0.001*
NLR	5.03 (2.96~8.68)	16.16 (10.45~23.49)	<0.001*
SII	1144.04 (506.36~1856.28)	3434.20 (2559.82~5903.08)	<0.001*
RDW-SD	42.60 (40.95~45.55)	43.05 (42.35~45.55)	0.349
LMR	3.20 (2.05~5.24)	1.59 (0.62~3.30)	<0.001*
Bısap 0h score	0 (0~1)	1 (1~2.75)	<0.001*
CTSI	1 (1~2)	4 (4~5.5)	<0.001*

Note: *P < 0.05 is accepted as a statistical significance level.

Abbreviations: AST, aspartate aminotransferase; ALT, alanine aminotransferase; TB, total bilirubin; GGT, gamma-glutamyl transferase; ALP, alkaline phosphatase; WBC, white blood cell; PLR, platelet to lymphocyte ratio; NLR, neutrophil to lymphocyte ratio; SII, systemic immune-inflammation index; RDW-SD, standard deviation of blood cell distribution width; LMR, lymphocyte to monocyte; Bisap, bedside index for severity in acute pancreatitis; CTSI, computed tomography severity index.

Table 2 Diagnostic Performances of SII, PLR, and NLR for Distinguishing Between MAP & SAP

Maker	Value	Sensitivity (%)	Specificity (%)	PLR*	NLR*	AUC Value	Youden Index
SII	2207.53	92.9	87.7	7.55	0.08	0.920	0.806
PLR	195.08	82.1	84.9	5.43	0.21	0.877	0.670
NLR	9.68	82.1	82.2	4.61	0.21	0.811	0.643

Abbreviations: PLR*, positive likelihood ratio; NLR*, negative likelihood ratio; AUC, area under the curve.

Figure 1 Receiver operating characteristic (ROC) curve analysis for assessing the performance of the SII, PLR, and NLR in determining the severity of acute pancreatitis.

Table 3 Multivariate Logistic Regression for Severe Acute Pancreatitis

Variables	Odds Ratio	95% Confidence Interval		P-value
SII	1.001	1.000	1.002	0.037*
Bısap 0h score	2.774	1.003	7.448	0.043*
RDW-SD	1.019	0.831	1.250	0.853
Age	0.978	0.937	1.021	0.313
WBC	0.957	0.289	3.173	0.942
Platelet	1.003	0.991	1.014	0.672
Neutrophile	1.101	0.309	3.923	0.882
Monocyte	0.958	0.155	5.920	0.963
Gender (male)	0.250	0.050	1.245	0.250

Note: * P < 0.05 is accepted as statistical significance level.

Abbreviations: SII, systemic immune-inflammation index; Bisap, bedside index for severity in acute pancreatitis; RDW-SD, standard deviation of blood cell distribution width; WBC, white blood cell.