Abstract
BackgroundThe systemic immune-inflammation index (SII), based on peripheral platelet, neutrophil and lymphocyte counts, has been proven to be a promising prognostic indicator in various diseases. Hip fracture is a common injury among the older adults, and has become a global public health problem with high mortality and disability rates. However, the relationship between SII and the prognosis of hip fracture is not yet well-known. The aim of the this study was to explore the predictive value of SII in older adults with hip fracture undergoing surgery.MethodsThis was a prospective cohort study performed from January 2014 to December 2018 at a orthopaedic center, China. The SII was calculated as platelet×neutrophil/lymphocyte counts. Univariable and multivariable Cox proportional hazard models were used to assess the association between SII and all-cause mortality.ResultsA total of 290 older adults with hip fracture were included, and the mean (SD) age was 77.6 (8.6) years, and 189 (65.2%) were female. The median (IQR) SII was 759.4 (519.0–1128.7) × 109/L. After a median follow-up time of 33.4 months, 13 (4.5%), 26 (9.0%) and 54 (18.6%) patients died within the 30-day, 1-year and last follow-up, respectively. Multivariable Cox analysis revealed that each increase of 100 units of SII was associated with a 8% increased hazard of death at 1-year follow-up (HR = 1.08, 95% CI: 1.01–1.17, p = 0.033), and 9% increased hazard of death at last follow-up (HR = 1.09, 95% CI: 1.03–1.15, p = 0.003).ConclusionsSII is associated with poor all-cause mortality in older adults with hip fracture undergoing surgery, and deserves further investigation and application in clinical practice.
Highlights
The systemic immune-inflammation index (SII), based on peripheral platelet, neutrophil and lymphocyte counts, has been proven to be a promising prognostic indicator in various diseases
In order to predict the prognosis of hip fracture, many assessment tools have been developed, such as Nottingham Hip Fracture Score (NHFS) [8, 9], Physiologic and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) [10, 11], and Almelo Hip
Baseline characteristics Between January 2014 and December 2018, a total of 920 hip fracture patients treated at our orthopaedic center, and 660 patients have been consecutively included in the hip fracture database
Summary
The systemic immune-inflammation index (SII), based on peripheral platelet, neutrophil and lymphocyte counts, has been proven to be a promising prognostic indicator in various diseases. The aim of the this study was to explore the predictive value of SII in older adults with hip fracture undergoing surgery. Some inflammatory markers, such as interleukin-6 (IL-6), C-reactive protein (CRP), prognostic nutritional index ratio (PNI), CRP/PNI ratio, and neutrophil-to-lymphocyte ratio (NLR) were found to be independently associated with increased early and longterm mortality after hip fracture [14,15,16,17,18,19]. We firstly reported that high platelet-to-lymphocyte ratio (PLR) was associated with increased 1 year all-cause mortality in older adults with hip fracture [27]. As far as we know, no studies have investigated the relationship between SII and mortality in older adults with hip fracture. The aim of this study was to explore the predictive value of SII in older adults with hip fracture
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