Relationship between Systemic Immune-inflammation Index and Mortality in Intensive Care Patients Diagnosed with Crimean-Congo Hemorrhagic Fever

Abstract

Objective: To evaluate the power of the systemic immune-inflammation index in the prediction of mortality in severe Crimean--Congo hemorrhagic fever patients. Study Design: Observational study. Place and Duration of Study: Department of Anaesthesiology and Reanimation, Sivas Cumhuriyet University, Sivas, Turkey, from January to June 2022. Methodology: Intensive care patients diagnosed with Crimean-Congo hemorrhagic fever, between January 2012 and January 2022, were included. Demographic data, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and systemic immune inflammation index were recorded. Receiver operating characteristic analysis, Cox regression analysis and Kaplan-Meier mortality analyses were done. Results: A cut-off value <1.85 for neutrophil to lymphocyte ratio showed 41.67% sensitivity and 97.06% specificity. A cut-off value <80.75 for the systemic immune-inflammation index showed 84.72% sensitivity and 76.47% specificity. A cut-off value <37.86 for platelet-to- lymphocyte ratio showed 84.72% sensitivity and 73.53% specificity. In patients with systemic immune inflammation index value <80.75, the mortality rate increased 2.549 times and 3.732 times in patients with a platelet-to-lympho cyte ratio value <37.86. Conclusion: Similar sensitivity and specificity levels were found for systemic immune-inflammation index and platel-to-lympho cyte ratio regarding the mortality prediction power and impact on mortality. Both tests can be used for the prediction of mortality during the hemorrhagic period in patients with severe Crimean-Congo Hemorrhagic Fever.