Role of systemic inflammation response index and prognostic nutritional index in the prediction of moderate-to-severe bronchopulmonary dysplasia in very preterm infants.
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Abstract
Background: Bronchopulmonary dysplasia (BPD) is a severe chronic lung disease that primarily affects premature infants. BPD usually comes with delayed diagnosis, and the lung injury at the time of confirmed diagnosis is irreversible. The inflammatory response is a crucial pathogenic factor for BPD. The combination of prognostic nutritional index (PNI) and systemic inflammation response index (SIRI) is a comprehensive indicator that can reflect the balance between immune status and host inflammatory response. This study aimed to explore the predictive ability of SIRI and PNI for moderate-to-severe BPD (msBPD) in premature infants.
Methods: The research involved infants born before 32 weeks of gestational age (GA). The division of patients resulted in two groups: the control group with no or mild BPD and the msBPD group. Relevant data were collected to compare the differences regarding clinical data; SIRI and PNI were calculated within 24 hours after birth and at the time of diagnosis of BPD [at 36 weeks of postmenstrual age (PMA)]. The ability of SIRI and PNI to predict msBPD was evaluated by logistic regression analysis.
Results: A total of 491 infants were included in the study, with 435 infants in the control group and 56 infants in the msBPD group. The msBPD group exhibited lower PNI levels and higher SIRI levels compared to the control group. The area under the curve (AUC) value [95% confidence interval (CI): of SIRI and PNI were 0.599 (0.514-0.685) and 0.588 (0.504-0.672)], and the cut-off values were >1.927 and <34.105, respectively, within 24 hours after birth. The AUC value of SIRI and PNI were 0.602 (0.515-0.689) and 0.647 (0.569-0.725), and the cut-off values were >5.175 and <45.080, respectively, for the diagnosis of BPD at 36 weeks of PMA.
Conclusions: SIRI and PNI have a certain predictive and diagnostic values for managing msBPD in premature infants.
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