scholarly journals Comparison of Systemic Immune-Inflammation Index (SII), Early Warning Score (ANDC) and Prognostic Nutritional Index (PNI) in Hospitalized Patients with Malignancy, and Their Influence on Mortality from COVID-19

Author(s):  
Muge Bilge ◽  
Isil Kibar Akilli ◽  
Aylia Yesilova ◽  
Kadriye Kart Yasar

Abstract Introduction: COVID-19 pandemic is a serious cause of increased mortality in patients having malignancy. Therefore, to help predict the clinical progression of those patients with COVID-19 who have multiple comorbidities as cancer, we need various indices whose parameters we can easily measure and rapidly calculate. We evaluated several biological indicators based on inflammation and/or nutritional status, such as systemic immune-inflammation index (SII), early warning score (ANDC) and prognostic nutritional index (PNI) in hospitalized COVID-19 patients with and without malignancies for a prognostic significance. Methodology: This is a retrospective and observational study on 186 patients with SARS-CoV-2, who were diagnosed with COVID-19 by real-time PCR testing and hospitalized due to COVID-19 pneumonia. 75 patients had various malignancies, and the rest (111), having a similar age and comorbidity profile based on propensity score matching, had no malignancy. Results: None of the measures as neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (MLR), monocyte to lymphocyte ratio (PLR), SII, PNI or ANDC was found to be significantly different between two groups. Mortality ratio was found to be significantly higher in malignancy group (17,3%). Odds ratio for the mortality, OR:2,39 (%95 CI:1,80 -3,16) was found to be significantly higher for the malignancy group, even though the duration of hospitalization was statistically similar for both groups. PNI was found to be significantly lower for deceased patients compared with survivors in the malignancy group. Contrarily, ANDC was found to be significantly higher for deceased patients in the malignancy group. Conclusions: PNI and ANDC have independent predictive power on determining the in-hospital death in COVID-19 malignancy cases. It is suggested that ANDC seems to be a more sensitive score than SII in COVID-19 cases with malignancies.

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Muge Bilge ◽  
Isil Kibar Akilli ◽  
Ekrem Bilal Karaayvaz ◽  
Aylia Yesilova ◽  
Kadriye Kart Yasar

Abstract Introduction We evaluated several biological indicators based on inflammation and/or nutritional status, such as systemic immune-inflammation index (SII), early warning score (ANDC) and prognostic nutritional index (PNI) in hospitalized COVID-19 patients with and without malignancies for a prognostic significance. Methodology This is a retrospective and observational study on 186 patients with SARS-CoV-2, who were diagnosed with COVID-19 by real-time PCR testing and hospitalized due to COVID-19 pneumonia. 75 patients had various malignancies, and the rest (111), having a similar age and comorbidity profile based on propensity score matching, had no malignancy. Results None of the measures as neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, monocyte to lymphocyte ratio, SII, PNI or ANDC was found to be significantly different between two groups. Odds ratio for the mortality, OR 2.39 (%95 CI 1.80–3.16) was found to be significantly higher for the malignancy group, even though the duration of hospitalization was statistically similar for both groups. PNI was found to be significantly lower for deceased patients compared with survivors in the malignancy group. Contrarily, ANDC was found to be significantly higher for deceased patients in the malignancy group. Conclusions PNI and ANDC have independent predictive power on determining the in-hospital death in COVID-19 malignancy cases. It is suggested that ANDC seems to be a more sensitive score than SII in COVID-19 cases with malignancies.


2019 ◽  
Vol 13 (18) ◽  
pp. 1565-1575 ◽  
Author(s):  
Cem Mirili ◽  
Semra Paydas ◽  
Tuba Korkmaz Kapukaya ◽  
Ali Yılmaz

Aim: To evaluate the prognostic significance of neutrophil lymphocyte ratio, prognostic nutritional index, systemic immune-inflammation index (SII) and B2M in Hodgkin Lymphoma (HL). Materials & methods: Neutrophil–lymphocyte ratio, prognostic nutritional index, SII and B2M were analyzed to assess their prognostic value via the Kaplan–Meier method and Cox regression analysis in 122 HL patients, retrospectively. Results: SII was found to have the highest area under curve and the most sensitive and specific among all markers. In univariate analyses, all four parameters were prognostic for overall survival and progression-free survival, in multivariate analyzes only SII was found to be independent factors for both of them. Conclusion: SII can be suggested as a novel independent and better prognostic factor for predicting overall survival and progression-free survival in HL.


2020 ◽  
Vol 7 (1) ◽  
pp. 351-359 ◽  
Author(s):  
Cem Mirili ◽  
Mehmet Bilici

Objective: Systemic inflammatory response markers have prognostic significance in many cancer types. Although the prognostic values of neutrophil/lymphocyte (NLR), and platelet/lymphocyte ratios (PLR) have been shown in patients with Endometrial Cancer (EC) there is no information in the literature about systemic immune-inflammation index (SII) and prognostic nutritional index (PNI). In our study, we aimed to reveal the prognostic role of SII and PNI in EC. Material and Methods: Medical data for 101 patients with EC were reviewed retrospectively. NLR, PLR, SII and PNI values were dichotomized based on receiver operating characteristic (ROC) curve analysis (cut-off values: 3.3; 177; 1035.9, and 38, respectively). At the time of diagnosis concentrations of these four serum inflammatory markers were analyzed to determine their potential association with clinicopathologic characteristics and to assess their prognostic values via the Kaplan-Meier method and multivariate Cox regression analysis. Results: Patients with higher NLR, PLR, SII, and lower PNI values had shorter progression-free survival (PFS) and overall survival (OS) times. Higher NLR, SII, and lower PNI, were associated with FIGO stages, lymph node involvement, lymphovascular invasion, and cervical stromal invasion while additionally NLR and PNI were associated with worse ECOG performance scores (2-3)  and myometrial invasion. In univariate analyses, all these four variables were prognostic for both OS and PFS, whereas in multivariate analyzes only NLR, SII and PNI were found to be independent factors for OS and PFS. Conclusion: For the first time in the literature SII and PNI were determined to be independent prognostic factors for both OS and PFS in EC.


2021 ◽  
Author(s):  
Gulsah Tuncer ◽  
Serkan Surme ◽  
Osman F Bayramlar ◽  
Hatice K Karanalbant ◽  
Betul Copur ◽  
...  

Aim: We aimed to determine the prognostic values of the National Early Warning Score 2 (NEWS2) and laboratory parameters during the first week of COVID-19. Materials & methods: All adult patients who were hospitalized for confirmed COVID-19 between 11 March and 11 May 2020 were retrospectively included. Results: Overall, 611 patients were included. Our results showed that NEWS2, procalcitonin, neutrophil/lymphocyte ratio and albumin at D0, D3, D5 and D7 were the best predictors for clinical deterioration defined as a composite of ICU admission during hospitalization or in-hospital death. Procalcitonin had the highest odds ratio for clinical deterioration on all days. Conclusion: This study provides a list of several laboratory parameters correlated with NEWS2 and potential predictors for clinical deterioration in patients with COVID-19.


2021 ◽  
Author(s):  
Ali Yılmaz ◽  
Melih Şimşek ◽  
Zekeriya Hannarici ◽  
Mehmet E Büyükbayram ◽  
Mehmet Bilici ◽  
...  

Aim: To show the prognostic significance of the glucose-to-lymphocyte ratio (GLR) in hepatocellular carcinoma (HCC). Patients & methods: A total of 150 patients with advanced HCC who were treated with sorafenib in our center between January 2011 and December 2019 were included in the study retrospectively. Neutrophil-to-lymphocyte ratio, systemic immune-inflammation index, lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio, prognostic nutritional index and GLR were analyzed to assess their prognostic value using Kaplan–Meier and Cox regression analysis before and after propensity score matching (PSM). Results: In univariate analysis before and after PSM, albumin–bilirubin grade, neutrophil-to-lymphocyte ratio, systemic immune-inflammation index, lymphocyte-to-monocyte ratio, prognostic nutritional index, AFP level and GLR were found to be significantly associated with both progression-free and overall survival. In multivariate analysis before and after PSM, GLR, albumin–bilirubin grade and AFP were determined to be independent prognostic factors for progression-free and overall survival. Conclusion: The GLR prior to sorafenib treatment is a new prognostic biomarker that may predict survival in advanced HCC.


ESMO Open ◽  
2018 ◽  
Vol 3 (6) ◽  
pp. e000425 ◽  
Author(s):  
Gema Bruixola ◽  
Javier Caballero ◽  
Federica Papaccio ◽  
Angelica Petrillo ◽  
Aina Iranzo ◽  
...  

BackgroundLocally advanced head and neck squamous cell carcinoma (LAHNSCC) is a heterogeneous disease in which better predictive and prognostic factors are needed. Apart from TNM stage, both systemic inflammation and poor nutritional status have a negative impact on survival.MethodsWe retrospectively analysed two independent cohorts of a total of 145 patients with LAHNSCC treated with induction chemotherapy followed by concurrent chemoradiotherapy at two different academic institutions. Full clinical data, including the Prognostic Nutritional Index (PNI), neutrophil to lymphocyte ratio and derived neutrophil to lymphocyte ratio, were analysed in a training cohort of 50 patients. Receiver operating characteristic curve analysis was used to establish optimal cut-off. Univariate and multivariate analyses of prognostic factors for overall survival (OS) were performed. Independent predictors of OS identified in multivariate analysis were confirmed in a validation cohort of 95 patients.ResultsIn the univariate analysis, low PNI (PNI<45) (p=0.001), large primary tumour (T4) (p=0.044) and advanced lymph node disease (N2b-N3) (p=0.025) were significantly associated with poorer OS in the validation cohort. The independent prognostic factors in the multivariate analysis for OS identified in the training cohort were dRNL (p=0.030) and PNI (p=0.042). In the validation cohort, only the PNI remained as independent prognostic factor (p=0.007).ConclusionsPNI is a readily available, independent prognostic biomarker for OS in LAHNSCC. Adding PNI to tumour staging could improve individual risk stratification of patients with LAHNSCC in future clinical trials.


2020 ◽  
Author(s):  
Shuxin Sun ◽  
Chaobin He ◽  
Jun Wang ◽  
Xin Huang ◽  
Jiali Wu ◽  
...  

Abstract Background Growing evidence indicates that systemic inflammatory response plays an important role in cancer development and progression. Several inflammatory markers have been reported to be associated with the clinical outcomes in patients with various types of cancer. This study was designed to evaluate the prognostic value of the inflammatory indexes in patients suffering from ampullary cancer (AC) who underwent pancreaticoduodenectomy (PD). Methods We retrospectively reviewed a database of 358 patients with AC who underwent PD between 2009 and 2018. R software was used to compare the area under the time-dependent receiver operating characteristic (ROC) curves (AUROCs) of the inflammation-based indexes, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), modified Glasgow Prognostic Score (mGPS), prognostic nutritional index (PNI) and prognostic index (PI), in terms of their predictive value of survival. The survival differences of these indexes were compared by Kaplan-Meier method and univariate and multivariate analyses were performed to determine the prognostic factors of progress-free survival (PFS) and overall survival (OS). Results The estimated 1-, 2-, and 3-year OS and PFS rates were 83.9%, 65.8%, 55.2% and 58.0%, 42.8%, 37.8%, respectively, for the entire cohort. The survival differences were significant in terms of OS and PFS when they were stratified by these inflammation-based indexes. The comparisons of AUROCs of these inflammation-based indexes illustrated that NLR and PI displayed highest prognostic value, compared to other indexes. When NLR and PI were combined, NLR-PI showed even higher AUROC values and was identified as a significant prognostic factor in terms of OS and PFS. Conclusion Specific inflammatory indexes, such as NLR, PLR and PI, were found to be able to predict the OS or PFS of patients. As a novel inflammatory index, the level of NLR-PI, which can be regarded as a more useful prognostic index, exhibited strong predictive power for predicting prognosis of patients with AC after PD procedure.


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