全身炎症免疫指数与急诊内科患者住院风险相关性的研究

Study on the Correlation between Systemic Immune-Inflammation Index and the Risk of Hospitalization in Emergency Medical Patients

摘要: 目的：探讨全身炎症免疫指数(Systemic Immune-Inflammation Index, SII)与急诊内科患者住院风险的相关性。方法：纳入2022年5月~2022年9月于重庆医科大学附属第二医院江南院区急诊内科就诊的患者。收集患者的人口统计学、生命体征和实验室数据，将纳入的患者按照SII四分位数分成q1、q2、q3、q4四个组。采用logistic回归分析识别患者住院的危险因素，建立3个模型探究不同水平SII与患者住院的关系，绘制多因素回归的限制性立方样条图评估SII作为连续变量时与患者住院风险的相关性，采用相乘交互作用分析SII与不同危险因素之间的相互影响。结果：本研究共纳入2110名患者。当SII作为连续变量时，单因素logistic分析结果提示SII是急诊患者住院的危险因素(OR = 1.024, 95% CI: 1.018~1.031, p < 0.05)，经调节所有混杂因素后结果保持一致(OR = 1.014, 95% CI: 1.006~1.022, p < 0.05)；当SII作为分类变量时，以q1组为参考，q4组患者住院风险显著增加且经过调整所有混杂因素后结果仍然一致(OR = 1.382, 95% CI: 1.027~1.861, p < 0.05)。限制性立方样条图提示当SII > 755.13时，SII的升高与患者住院风险的增加呈线性正相关(p = 0.184)。相乘交互作用结果显示SII与尿素氮存在拮抗作用(OR = 0.967, p = 0.009)。结论：高SII与急诊患者住院风险增加相关且与尿素氮存在拮抗交互作用。因此，SII也许能用于评估急诊患者的住院风险。

Abstract: Objective: To explore the correlation between the systemic immune-inflammation index (SII) and hospitalization in emergency internal medicine patients. Methods: Patients who visited the Emergency Department of Jiangnan Campus of the Second Affiliated Hospital of Chongqing Medical University from May 2022 to September 2022 were enrolled. Demographic, vital signs and laboratory data of the patients were collected, and the included patients were divided into four groups according to SII quartile: q1, q2, q3 and q4. Logistic regression analysis was used to identify the risk factors of hospitalization, three models were established to explore the relationship between different SII and hospitalization, and a restricted cubic spline plot of multivariate regression was drawn to evaluate the correlation between SII as a continuous variable and hospitalization risk of patients. Multiplicative interaction analysis was used to examine the effects between SII and different risk factors. Results: A total of 2110 patients were included in this study. When SII is used as a continuous variable, the results of univariate logistic analysis suggest that SII is a risk factor for hospitalization in emergency patients (OR = 1.024, 95% CI: 1.018~1.031, p < 0.05), and the results were consistent after adjustment for all confounders (OR = 1.014, 95% CI: 1.006~1.022, p < 0.05); When SII was used as a categorical variable, only group q4 patients had an increased risk of hospitalization and the results remained consistent after adjusting for all confounding factors (OR = 1.382, 95% CI: 1.027~1.861, p < 0.05), using group q1 as a reference. The restricted cubic spline plots indicated that when SII > 755.13, the increase of SII was positively linearly correlated with the increase of hospitalization risk (p = 0.184). The interaction results showed that there was a multiplicative interaction between SII and urea nitrogen, and the two were antagonistic (OR = 0.967, p = 0.009). Conclusions: High SII is associated with an increased risk of hospitalization in emergency patients; there is an antagonistic interaction between SII and urea nitrogen on hospitalization. Therefore, SII may be used to assess the risk of hospitalization in emergency patients.