A study of the correlation between immune markers and the prognosis of acute pulmonary embolism.

Background

   Inflammatory mechanisms play an important role in acute pulmonary embolism (APE). The aim of this study was to compare the predictive value of NLR, SII, SIRI, PLR, and albumin on the poor prognosis of acute pulmonary embolism in order to determine the potential of their application in early recognition of the severity of acute pulmonary embolism.

Methods

Patients with acute pulmonary embolism in the People's Hospital of Inner Mongolia Autonomous Region were selected for this retrospective study. Data on NLR, SII, SIRI, PLR, albumin, demographics and clinical characteristics of the patients at the time of admission were collected for the study. Patients who had an outcome event were defined as the study group and the remaining patients were defined as the control group. The correlation between the indicators of the two groups of patients was analyzed, and a logistic regression model was established to analyze the relationship between inflammatory indicators and the occurrence of outcome events, and the ROC curve of inflammatory indicators predicting the occurrence of outcome events was plotted.

Results

Of the 235 patients diagnosed with APE, 18 (7.7%) had outcome events. Of these, the study group had a higher incidence of syncope (P = 0.037) and significantly lower systolic and diastolic blood pressure (P < 0.001). Compared with the control group, the study group had a higher NLR (P = 0.017), SII (P = 0.018), and SIRI (P = 0.044), and significantly lower albumin levels (P < 0.001). According to univariate logistic regression analysis, after adjusting for covariates such as age and gender, high levels of SII may be a risk factor for the occurrence of an outcome event, whereas low levels of serum albumin still had a significant effect on the outcome event.The ROC curves showed that serum albumin was a stronger predictor of the outcome event (AUC = 0.880, 95% CI: 0.803-0.956).

Conclusions

High SII and low serum albumin levels are associated with poor prognosis in acute pulmonary embolism.