The prognostic importance of the pan-immune-inflammation value in patients with septic shock

Abstract Introduction The purpose of this study was to determine whether the pan-immune-inflammation value (PIV), a novel biomarker combining neutrophil platelet, monocyte, and lymphocyte counts, some of the most widespread indicators of systemic inflammation, can predict mortality and prognosis in...

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Main Author: Yasemin Bozkurt Turan
Format: Article
Language:English
Published: BMC 2024-01-01
Series:BMC Infectious Diseases
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Online Access:https://doi.org/10.1186/s12879-023-08963-w
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author Yasemin Bozkurt Turan
author_facet Yasemin Bozkurt Turan
author_sort Yasemin Bozkurt Turan
collection DOAJ
description Abstract Introduction The purpose of this study was to determine whether the pan-immune-inflammation value (PIV), a novel biomarker combining neutrophil platelet, monocyte, and lymphocyte counts, some of the most widespread indicators of systemic inflammation, can predict mortality and prognosis in patients admitted to the intensive care unit (ICU) with septic shock. Method This prospective study was performed with 82 patients aged 18 or over admitted to a tertiary ICU with diagnoses of septic shock. Patients with hematological disease and neutropenia were excluded. PIV was calculated with the formula [neutrophil count (103/μL) × platelet count (103/μL) × monocyte count (103/μL)]/lymphocyte count (103/μL). Results Median age, presence of hypertension, Acute Physiology and Chronic Health Evaluation II (APACHE II) levels, and neutrophil, monocyte, and platelet counts were lower in the low-PIV group than in the high-PIV group (p < 0.05). The highest area under ROC curve (AUC) was determined for Sequential Organ Failure Assessment (SOFA) (0.94 (0.89 – 0.99)), followed by Glasgow Coma Scale (GCS) (0.81 (0.70 – 0.91)), APACHE II (0.80 (0.69 – 0.91)) and lactate (0.77 (0.67 – 0.88)). Median survival was longer in the low-PIV group than in the high-PIV group (28 (15.25 – 40.76) vs 16 (9.46 – 22.55) days, respectively, p < 0.05). The univariate Cox proportional hazards (CPH) model showed that high PIV (HR = 2.13 (1.03—4.38)), low GCS (HR = 3.31 (1.34 – 8.15)), high SOFA (HR = 9.41 (2.86 – 30.95)), high APACHE II (HR = 3.08 (1.47 – 6.45)), high lactate (HR = 6.56 (2.73 – 15.75)), and high procalcitonin (PCT) (HR = 2.73 (1.11 – 6.69)) values were associated with a decreased survival time among ICU patients (p < 0.05). The multivariate CPH model showed the age-adjusted risk estimates for these six laboratory parameters. High lactate (HR = 7.97 (2.19 – 29.08)) and high SOFA scores (HR = 4.85 (1.22 – 19.32)) were significantly associated with shorter survival in ICU patients (p < 0.05). Conclusion The findings of this research suggest that PIV could predict the longer survival in patients with septic shock. Despite PIV score’s capability to show inflammation, it is not significantly associated with mortality in the multivariate analysis.
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spelling doaj-art-8834731d065a48188b9bb5d45459319a2025-02-02T12:10:52ZengBMCBMC Infectious Diseases1471-23342024-01-012411910.1186/s12879-023-08963-wThe prognostic importance of the pan-immune-inflammation value in patients with septic shockYasemin Bozkurt Turan0Department of Critical Care, Marmara University Faculty of MedicineAbstract Introduction The purpose of this study was to determine whether the pan-immune-inflammation value (PIV), a novel biomarker combining neutrophil platelet, monocyte, and lymphocyte counts, some of the most widespread indicators of systemic inflammation, can predict mortality and prognosis in patients admitted to the intensive care unit (ICU) with septic shock. Method This prospective study was performed with 82 patients aged 18 or over admitted to a tertiary ICU with diagnoses of septic shock. Patients with hematological disease and neutropenia were excluded. PIV was calculated with the formula [neutrophil count (103/μL) × platelet count (103/μL) × monocyte count (103/μL)]/lymphocyte count (103/μL). Results Median age, presence of hypertension, Acute Physiology and Chronic Health Evaluation II (APACHE II) levels, and neutrophil, monocyte, and platelet counts were lower in the low-PIV group than in the high-PIV group (p < 0.05). The highest area under ROC curve (AUC) was determined for Sequential Organ Failure Assessment (SOFA) (0.94 (0.89 – 0.99)), followed by Glasgow Coma Scale (GCS) (0.81 (0.70 – 0.91)), APACHE II (0.80 (0.69 – 0.91)) and lactate (0.77 (0.67 – 0.88)). Median survival was longer in the low-PIV group than in the high-PIV group (28 (15.25 – 40.76) vs 16 (9.46 – 22.55) days, respectively, p < 0.05). The univariate Cox proportional hazards (CPH) model showed that high PIV (HR = 2.13 (1.03—4.38)), low GCS (HR = 3.31 (1.34 – 8.15)), high SOFA (HR = 9.41 (2.86 – 30.95)), high APACHE II (HR = 3.08 (1.47 – 6.45)), high lactate (HR = 6.56 (2.73 – 15.75)), and high procalcitonin (PCT) (HR = 2.73 (1.11 – 6.69)) values were associated with a decreased survival time among ICU patients (p < 0.05). The multivariate CPH model showed the age-adjusted risk estimates for these six laboratory parameters. High lactate (HR = 7.97 (2.19 – 29.08)) and high SOFA scores (HR = 4.85 (1.22 – 19.32)) were significantly associated with shorter survival in ICU patients (p < 0.05). Conclusion The findings of this research suggest that PIV could predict the longer survival in patients with septic shock. Despite PIV score’s capability to show inflammation, it is not significantly associated with mortality in the multivariate analysis.https://doi.org/10.1186/s12879-023-08963-wPan-immune-inflammation valueSeptic shockIntensive care
spellingShingle Yasemin Bozkurt Turan
The prognostic importance of the pan-immune-inflammation value in patients with septic shock
BMC Infectious Diseases
Pan-immune-inflammation value
Septic shock
Intensive care
title The prognostic importance of the pan-immune-inflammation value in patients with septic shock
title_full The prognostic importance of the pan-immune-inflammation value in patients with septic shock
title_fullStr The prognostic importance of the pan-immune-inflammation value in patients with septic shock
title_full_unstemmed The prognostic importance of the pan-immune-inflammation value in patients with septic shock
title_short The prognostic importance of the pan-immune-inflammation value in patients with septic shock
title_sort prognostic importance of the pan immune inflammation value in patients with septic shock
topic Pan-immune-inflammation value
Septic shock
Intensive care
url https://doi.org/10.1186/s12879-023-08963-w
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