Systemic Inflammatory Indices as New Biomarkers for Hemodynamically Significant Ductus Arteriosus

Increased oxygen tension and decreased prostaglandin levels cause ductal closure. The diagnostic role of systemic inflammatory indices in hemodynamically significant ductus arteriosus (hsPDA) in premature infants is unknown.

We aimed to evaluate the role of systemic inflammatory indices in the predictivity of hsPDA.

Premature infants with gestational weeks (GW) of <32 weeks were evaluated retrospectively. Systemic inflammatory indices neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), pan-immune- inflammation value (PIV), and systemic inflammation response index (SIRI) were calculated. Systemic inflammatory indices were compared between hsPDA and non-hsPDA groups. A p <0.05 was considered as statistically significant.

A total of 1228 patients were included in the study, including 447 patients in the hsPDA group and 781 patients in the non-hsPDA group. The PIV value [median (Q1 - Q3): 5.18 (2.38-10.42)] in the hsPDA group was statistically significantly higher than the PIV value [median (Q1 - Q3): 3.52 (1.41-6.45)] in the non-hsPDA group (p<0.001). According to the ROC analysis, the AUC value of PIV for the predictivity of hsPDA was 0.618, and the cutoff level was >8.66. After even multiple logistic regression analyses, PIV was shown to be a significant parameter for the diagnosis of hsPDA (OR 1.972, 95% CI 1.114-3.011. p=0.001).

A high PIV value may be a quickly used indicator with low-cost, simple, and easily accessible for the early diagnosis of hsPDA.