ArticleEuropean journal of medical research2023
Systemic immune-inflammation index (SII) and the risk of all-cause, cardiovascular, and cardio-cerebrovascular mortality in the general population.
Article in European journal of medical research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 2 of them syntheses that pooled it.
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Who cites it
61 citing papers in PubMed, 2 syntheses or guidelines pooled it, 70 citations in OpenAlex.
- Systemic immune-inflammation index as a novel biomarker for metabolic syndrome: A systematic review and meta-analysis.Medicine · 2026Pooled it
- Systemic immune inflammation index with all-cause and cause-specific mortality: a meta-analysis.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2024Pooled it
- The U-shaped correlation between the systemic immune-inflammation index and all-cause and cardiovascular mortality in hyperlipidemic patients: findings from NHANES 1999-2018.Annals of medicine · 2026Article
- Perioperative changes in systemic inflammatory markers predict major complications after distal pancreatectomy.Updates in surgery · 2026Article
- Systemic immune inflammation, physical function, and mortality in US adults: A prospective follow-up analysis of NHANES 2011 to 2014.Medicine · 2026Article
- Respiratory Versus Gastrointestinal Malignancies: Systemic Inflammation, Cardiovascular Burden, and All-Cause Mortality.Journal of clinical medicine · 2026Article
- Systemic Inflammatory Indices Predict Survival and Limb Outcomes after Revascularization for Chronic Limb-Threatening Ischemia.Journal of vascular research · 2026Article
- Prognostic value of the systemic immune-inflammation index in acute non-variceal upper gastrointestinal bleeding: a retrospective single-center cohort study.BMC emergency medicine · 2026Article
- Evaluation of Hemogram-Derived Inflammatory Markers in Healthy Cats.Veterinary sciences · 2026Article
- From wrist data to lifespan: elucidating inflammation-driven biological aging via activity rhythms captured by wearable devices.npj aging · 2026Article
- Investigating the association between systemic immune-inflammation index and female fertility: a retrospective cohort study.Journal of ovarian research · 2026Article
- Development and validation of a prediction model for 1-year all-cause rehospitalisation after discharge in patients with heart failure with preserved ejection fraction based on the systemic immune-inflammation index.Frontiers in cardiovascular medicine · 2026Article
- Impact of systemic immune-inflammation index and systemic inflammation response index on all-cause and cause-specific mortality: a community-based cohort study.Frontiers in medicine · 2026Article
- Clinical study on the value of TyG index combined with systemic immune-inflammation index for screening hospitalized patients with type 2 diabetic kidney disease.Frontiers in endocrinology · 2026Article
- Phospholipase A2 and Systemic-Immune Inflammation Index as Early Predictors of Neurotoxicity Induced by Acute Glufosinate Ammonium Poisoning: A Population-Based Case-Control Analysis.Emergency medicine international · 2026Article
- The association between APOE allele variants and inflammatory markers in a large-scale Chinese population.Lipids in health and disease · 2025Article
- Association between systemic immune-inflammation index and disease activity score 28 in patients with rheumatoid arthritis: a cross-sectional study.Scientific reports · 2025Article
- Essential and Toxic Elements in Cardiovascular Disease: Pathophysiological Roles and the Emerging Contribution of Hair Mineral Analysis.International journal of molecular sciences · 2025Review
- The role of systemic inflammation in the formation and rupture of intracranial aneurysms in moyamoya disease: a retrospective cohort study.Annals of medicine · 2025Article
- Development and Validation of Prognostic Models for Treatment Response of Patients with B-Cell Lymphoma: Standard Statistical and Machine-Learning Approaches.Journal of clinical medicine · 2025Article
1 more citing papers are in PubMed but not listed here.
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAn elevated systemic immune-inflammation index (SII) is associated with higher mortality in patients with coronary artery disease and other diseases. However, the potential of SII for predicting mortality in the general population has been underexplored. Therefore, this study aimed to analyze the relationship between the SII and all-cause, cardiovascular disease, and cardiocerebrovascular disease mortality in the general population.
methodsThis study involved 26,855 participants (≥ 18 years) from the National Health and Nutrition Examination Survey 1999-2014 who were grouped according to the SII tertiles. Survival differences between the groups were analyzed using log-rank tests and Kaplan-Meier plots. Furthermore, multivariate Cox regression and restricted cubic spline analyses were used to examine the relationship between the SII and all-cause, cardiovascular, and cardio-cerebrovascular mortality.
resultsOverall, 1947 (7.425%) participants died following an average follow-up of 87.99 ± 54.04 months. Among these, 325 (1.210%) deaths were related to cardiovascular diseases and 392 (1.459%) to cardio-cerebrovascular mortality. Kaplan-Meier analysis revealed statistically significant differences in all-cause, cardiovascular, and cerebrovascular mortality between the SII tertiles (log-rank test: all P < 0.001). Multi-adjusted models showed that participants in the highest tertile of SII had a higher risk of death from all-cause (hazard ratio [HR] = 1.48, 95% confidence interval [CI] 1.48-1.48) and cardiovascular mortality (HR = 1.60, 95% CI 1.60-1.61) compared with those in the lowest tertile. In addition, the restricted cubic spline curve indicated a nonlinear association between SII and all-cause mortality (P < 0.001), with threshold value of SII at 18.284. There was a 15% decrease in the risk of all-cause mortality for each twofold change in SII on the left flank (HR = 0.85, 95% CI 0.69-1.05) and a 42% increase (HR = 1.42, 95% CI 1.23-1.64) on the right flank of the inflection point. In addition, the risk of cardiovascular mortality increased nonlinearly by 39% per twofold change in SII (HR = 1.39, 95% CI 1.07-1.81). There was also a nonlinear increase in the risk of cardio-cerebrovascular mortality per twofold change in SII (HR = 1.29, 95% CI 1.00-1.66).
conclusionsIn the general population, the SII was significantly associated with all-cause, cardiovascular, and cardio-cerebrovascular mortality, regardless of the established risk factors.
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