背景:本研究的目的是评估在重症监护病房(ICU)监测的65岁以上患者中炎症标志物对感染和死亡率的影响。在这项研究中,我们试图确定泛免疫-炎症值(PIV);中性粒细胞-淋巴细胞比值(NLR);血小板-淋巴细胞比值(PLR);单核细胞-淋巴细胞比值(MLR);全身免疫-炎症指数(SII);全身免疫反应指数(SIRI);多种炎症指数(MII)1,2和3;CRP/白蛋白比值(在65岁以上的ICU患者中监测的预后标志物)的意义.方法:这个多中心,回顾性,我们对两个三级ICU收治的65岁及以上患者进行了队列研究.肝硬化患者,骨髓移植,恶性血液病,类固醇摄入量,目前的化疗治疗,入住ICU后的中性粒细胞减少症被排除在本研究之外.结果:共纳入333例患者。该组28天死亡率为31.8%。当检查与28天死亡率相关的每个炎症标志物时,CRP/白蛋白比被发现是比NLR和SIRI更好的指标,结果有统计学意义(AUC:0.665,95%CI:0.604-0.726,p<0.001)。NLR在区分死亡风险方面显示中等判别能力(AUC:0.593,95%CI:0.526-0.660,p=0.006)。尽管SIRI低于NLR,结果具有统计学意义(AUC:0.580,95%CI:0.514-0.646,p=0.019)。CRP/白蛋白比值是预测ICU老年患者死亡风险的最有效的炎症指标。结论:监测炎症标志物(尤其是CRP/白蛋白比值,NLR,SIRI,和MII1-2-3)在入住ICU的老年患者中,以准确预测28天死亡率。在目前的研究中,PIV的影响,MLR,PLR,和SII对老年ICU患者28天死亡率的预测无法证实。我们认为需要更多的临床研究来确定PIV的效果,MLR,PLR,和SII对老年ICU患者短期和长期预后和生存率的影响。
Background: The aim of the current study is to evaluate the effects of inflammation markers on infection and mortality in patients over 65 years of age monitored in the intensive care unit (ICU). In this study, we attempted to determine the significance of the pan-immune-inflammation value (PIV); the neutrophil-lymphocyte ratio (NLR); the platelet-lymphocyte ratio (PLR); the monocyte-lymphocyte ratio (MLR); the systemic immune-inflammatory index (SII); the systemic immune response index (SIRI); multi-inflammatory indices (MIIs) 1, 2, and 3; and the CRP/albumin ratio (a new biomarker) as prognostic and mortality markers in patients over 65 years of age being monitored in the ICU. Methods: This multicenter, retrospective, cohort study was conducted on patients aged 65 and over who were admitted to two tertiary-level ICUs. Patients with cirrhosis, bone marrow transplantation, hematologic malignancy, steroid intake, current chemotherapy treatment, and neutropenia upon admission to the ICU were excluded from this study. Results: A total of 333 patients were included in this study. The group\'s 28-day mortality was found to be 31.8%. When each inflammatory marker associated with 28-day mortality was examined, the CRP/albumin ratio was found to be a better indicator than both the NLR and the SIRI, and the results were statistically significant (AUC: 0.665, 95% CI: 0.604-0.726, and p < 0.001). The NLR showed moderate discriminative ability in distinguishing mortality risk (AUC: 0.593, 95% CI: 0.526-0.660, and p = 0.006). Although the SIRI was lower than the NLR, it produced a statistically significant result (AUC: 0.580, 95% CI: 0.514-0.646, and p = 0.019). The CRP/albumin ratio was the most effective inflammatory marker in predicting mortality risk in older patients admitted to the ICU. Conclusions: It is important to monitor inflammatory markers (especially CRP/albumin ratio, NLR, SIRI, and MII 1-2-3) in older patients admitted to the ICU in order to accurately predict 28-day mortality. In the current study, the effects of PIV, MLR, PLR, and SII on the prediction of 28-day mortality in older ICU patients could not be demonstrated. We believe that more clinical studies are needed to determine the effects of PIV, MLR, PLR, and SII on short- and long-term prognoses and survival in older ICU patients.