ArticleBMC infectious diseases2026
Association between systemic immune-inflammation index and ICU-acquired infection in critically Ill patients without infection: a competing risks analysis from a retrospective cohort.
Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
backgroundHealthcare-associated infections and their complications represent a predominant cause of morbidity and mortality in intensive care units (ICUs) globally. Several studies have reported that the systemic immune-inflammation index (SII) is associated with an increased risk of infection; however, its association with ICU-acquired infection (ICU-AI) remains unclear. We aimed to examine the association between SII and the subsequent risk of ICU-AI.
methodsWe conducted a retrospective cohort study using the MIMIC-IV database, including adult ICU patients without suspected infection at baseline. SII was calculated as platelet × neutrophil / lymphocyte count, based on values from the first 24 h of ICU admission. The primary outcome was ICU-AI, defined as suspected infection occurring after 48 h of ICU admission. Two competing risk regression models were employed to evaluate the association between SII and ICU-AI.
resultsAmong the 5,459 patients included, 627 (11.5%) developed ICU-AI. Higher SII (per 1,000-unit) was independently associated with an increased risk of ICU-AI in both models: adjusted cause-specific hazard ratio (CSHR), 1.06 (95% CI, 1.03-1.08; p < 0.001) and subdistribution hazard ratio (SHR), 1.05 (95% CI, 1.03-1.07; p < 0.001). When analyzed by quartiles, a significant dose-response relationship was observed (p for trend < 0.001). Compared with patients in the lowest quartile (Q1, SII ≤ 594 × 10⁹/L), those in Q3 (SII 1125-2201 × 10⁹/L) and Q4 (SII ≥ 2202 × 10⁹/L) showed progressively higher risks of infection, with adjusted CSHR of 1.44 (95% CI 1.11-1.86) and 1.76 (95% CI 1.37-2.26), and adjusted SHR of 1.51 (95% CI 1.17-1.93) and 1.96 (95% CI 1.54-2.49), respectively. Time-to-event curves showed distinct and consistent cumulative risk trajectories across SII quartiles.
conclusionElevated SII at ICU admission was independently associated with an increased risk of developing suspected secondary infection in infection-naïve critically ill patients.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.