ArticleFrontiers in medicine2026
Association of SIRI and NLPR with post-operative pneumonia in middle-aged and elderly patients after hip fracture surgery.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Post-operative pneumonia (POP) is one of the most common complications following hip fracture surgery. The Systemic Inflammation Response Index (SIRI) and the Neutrophil-to-Lymphocyte-to-Platelet Ratio (NLPR) are novel inflammatory markers derived from peripheral blood cell counts. This study aims to evaluate the association of SIRI and NLPR at admission with hospital-acquired post-operative pneumonia in middle-aged and elderly patients after hip fracture surgery. Methods: A retrospective study was conducted with 452 patients aged 45 years or older who underwent hip fracture surgery. The Systemic Inflammation Response Index (SIRI) and the Neutrophil-to-Lymphocyte-to-Platelet Ratio (NLPR) were calculated based on peripheral blood cell counts (including neutrophil, monocyte, lymphocyte, and platelet counts) measured at admission. According to the occurrence of hospital-acquired post-operative pneumonia, patients were divided into a pneumonia group ( Results: A total of 452 patients were included in this study, of whom 25 (5.53%) developed post-operative pneumonia. Both SIRI and NLPR showed a positive association with the risk of pneumonia after hip fracture surgery. Both SIRI and NLPR showed moderate discriminative performance (AUC: 0.701 and 0.738, respectively). The difference between the two AUCs was not statistically significant (DeLong test, Conclusions: Both SIRI and NLPR are associated with the occurrence of hospital-acquired post-operative pneumonia in middle-aged and elderly patients with hip fracture. Both markers demonstrated moderate discriminative ability, with high negative predictive values, suggesting they may be useful as auxiliary screening tools for ruling out POP in low-risk patients. The numerically higher AUC of NLPR did not reach statistical significance compared with SIRI. However, given the low positive predictive value, it is more suitable for ruling out low-risk patients rather than definitively identifying those who will develop post-operative pneumonia. Its clinical utility as an early warning indicator requires further external validation.
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