The Role of Systemic Inflammatory Indices in Predicting Composite Adverse Outcomes of Peripartum Hemorrhage Treated...

Hematological systemic inflammatory markers have been used in predicting the severity and prognosis of the disease in recent years. We aimed to determine the value of neutrophil to lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and platelet to lymphocyte ratio (PLR) in the prediction of composite adverse outcomes (CAO) in peripartum hemorrhage requiring fibrinogen administration. This retrospective cohort study was conducted with pregnant women who were treated with perioperative fibrinogen concentrate in the Department of Perinatology, Ministry of Health Ankara City Hospital between January 01, 2023 and June 01, 2023. NLR (neutrophil/lymphocyte), PLR (platelet/lymphocyte), and SII (NLR x platelet count) were calculated using the complete blood cell count at the first hospital admission. Patients were divided into two groups based on the presence (n = 31) or absence (n = 60) of a composite adverse outcome. NLR, PLR, and SII values were compared between the two subgroups. We used receiver operating characteristic (ROC) curves to assess the performance of complete blood cell indices to predict CAOs. Statistically significantly higher values for NLR, PLR, and SII were observed in the CAO group (p < 0.05). Optimal cut-off values were 774.42 (70.5% sensitivity, 47.7% specificity, p < 0.001), 103.09 (78.7% sensitivity, 53.3% specificity, p < 0.001), and 3.33 (73.8% sensitivity, 50% specificity, p < 0.001), for Sİİ, PLR, and NLR, respectively. NLR, PLR and SII are non-invasive, low-cost, simple and repeatable indices. These indices could help clinicians identify patients at high-risk for CAO in severe postpartum hemorrhage and customise individualised therapeutic regimens.