Investigating Utility of the Preoperative Systemic Immune-Inflammatory Index in Chronic Rhinosinusitis

Background

CRS is a multifactorial pathology associated with inflammatory comorbidities including asthma, allergic rhinitis (AR) and nasal polyposis (NP). The systemic immune-inflammatory index (SII) has been shown to have prognostic efficacy in gauging systemic inflammation.

Objective

To evaluate the potential utility of the SII in assessing the extent of surgery and CRS-mediated comorbidities in patients undergoing ESS.

Methods

13-year retrospective study of 147 adults undergoing ESS with preoperative platelet, neutrophil and lymphocyte counts for SII calculation ((platelets × neutrophils)/lymphocytes). Lund-Mackay scores, surgery extent and comorbidities were collected. For analyses, numeric versus categorical utilised a two-tailed t-test, categorical versus categorical utilised a Chi-square test of independence. Significance set at p < 0.05.

Results

147 patients met criteria, 75 had CRS and 72 had other sinonasal conditions (exploratory control). Average SII for all patients was 1080.6 ± 1134.6 (range 0–8119, median 735). Significant differences in average SII existed between CRS and other sinonasal disorders (1479 ± 1186 vs. 1007 ± 1082, p = 0.013). No significant differences were found in Lund-McKay scores between CRS patients with SII above or below previously reported critical thresholds (i.e., SII > 330 or > 895.6). Significant inverse association was observed between comorbidities and SII in CRS patients; those with SII < 895.6 had statistically significant higher prevalence of asthma (p = 0.001) and AR (p = 0.0143). No association was found between SII and nasal polyps, or with number of sinuses opened during surgery.

Conclusion

CRS patients requiring ESS had higher SII values than those with other indications. Contrary to previous reports, our study found that SII in CRS patients was inversely associated with asthma and AR, and was not associated with surgical extent.