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The impact of systemic inflammation index on prolonged mechanical ventilation after cardiac surgery: a retrospective

Quan Liu1, Yifei Zhou2,1, Xu Cao1

  • 1Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, Jiangsu, China.

Journal of Cardiothoracic Surgery
|July 10, 2025
PubMed
Abstract

Insights

Elevated preoperative Systemic Inflammation Index (SII) predicts prolonged mechanical ventilation (PMV) after cardiac surgery. This finding aids in identifying at-risk patients for tailored treatment and improved outcomes.

Area of Science:

  • Cardiology
  • Critical Care Medicine
  • Surgical Outcomes

Background:

  • Prolonged mechanical ventilation (PMV) is a significant concern after cardiac surgery, despite advances in care.
  • Identifying predictors of PMV is crucial for improving patient outcomes.

Purpose of the Study:

  • To investigate the association between the Systemic Inflammation Index (SII) and PMV occurrence.
  • To evaluate the medium-term prognostic impact of SII in cardiac surgery patients.

Main Methods:

  • Retrospective observational study of 1128 adult cardiac surgery patients undergoing cardiopulmonary bypass (CPB).
  • PMV defined as mechanical ventilation >24 hours post-surgery.
  • Multivariate logistic regression and Kaplan-Meier survival analysis were used.

Main Results:

  • Higher preoperative SII levels correlated with increased likelihood of PMV and longer hospital stays.
  • Independent predictors of PMV included age, female gender, chronic lung disease, preoperative SII, and intraoperative plasma infusion.
  • Each 100-unit increase in SII raised PMV risk by 7%; elevated SII linked to lower survival rates.

Conclusions:

  • Elevated preoperative SII is a significant predictor of PMV following cardiac surgery.
  • Early identification of patients with high SII can guide individualized treatment strategies.
  • This approach may improve postoperative outcomes in cardiac surgery patients.
Keywords:
Cardiac surgeryPostoperative outcomesProlonged mechanical ventilation (PMV)Risk factorsSystemic inflammation index (SII)

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