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A Clinical Cut-Off Value for the Systemic Immune-Inflammation Index to Predict Frequent Exacerbations in Stable COPD.
Ozlem Sengoren Dikis1, Ceren Degirmenci2, Sabri Serhan Olcay1
1Department of Chest Diseases, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla 48000, Türkiye.
Medicina (Kaunas, Lithuania)
|March 28, 2026
Summary
The Systemic Immune-Inflammation Index (SII) measured during stable chronic obstructive pulmonary disease (COPD) is linked to frequent exacerbations. An SII threshold of 1082.79 may help identify high-risk COPD patients in outpatient settings.
Area of Science:
- Pulmonology
- Immunology
- Biomarkers
Background:
- Acute exacerbations (AECOPD) are key drivers of clinical instability in COPD.
- Frequent exacerbators (≥2/year) face increased morbidity and healthcare use.
Purpose of the Study:
- To assess the association between the Systemic Immune-Inflammation Index (SII) and frequent exacerbations in COPD patients.
- To establish a clinically applicable SII threshold for risk stratification.
Main Methods:
- Retrospective observational cohort study of 159 COPD patients.
- SII calculated from hemogram parameters during stable periods.
- Follow-up for 1 year to identify frequent exacerbations (≥2 AECOPD).
- ROC analysis and logistic regression used for association and threshold determination.
Main Results:
- SII > 1082.79 was independently associated with frequent exacerbations (OR=3.029, p=0.002).
- The SII showed modest discriminatory performance (AUC=0.591, p=0.049).
- Other hemogram-derived indices lacked independent prognostic significance.
Conclusions:
- The SII, a simple hemogram-based index, is a potential predictor of frequent exacerbations in stable COPD.
- An SII threshold of 1082.79 may aid in identifying high-risk patients for targeted management.
- Further prospective external validation is needed due to study limitations (single-center, predominantly male cohort).
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