Forecasting complications: The role of inflammatory indices in acute peripheral vascular pathologies

This study aimed to evaluate the association of hematological and biochemical markers with the development of complications and mortality in patients undergoing surgical treatment for acute peripheral arterial thromboembolism or traumatic vascular injury. In addition to classic inflammatory indicators, the prognostic value of derived parameters such as the Inflammatory Burden Index (IBI) and Systemic Immune-Inflammation Index (SII), which have recently gained prominence in the literature and whose clinical applicability is debated, was analyzed.

A retrospective evaluation was conducted on 86 patients who underwent surgical treatment between 2022 and 2025 (thromboembolism: n = 27, trauma: n = 59). Patients were subgrouped based on clinical outcomes such as complications, mortality, amputation, and revision. The relationship between these clinical outcomes and inflammatory markers derived from hemogram parameters, including neutrophil-to-lymphocyte ratio (NLR), CRP, IBI, SII, and initial lactate levels, was statistically analyzed. Each group was evaluated internally, and no comparisons were made between groups.

In the thromboembolism group, IBI, SII, NLR, and lactate levels were significantly higher in patients who developed mortality (p < 0.05). IBI > 100, SII > 1500, and NLR > 5, along with lactate > 3.5 mmol/L, were significantly associated with an increased risk of mortality, complications, and amputation, respectively. In the trauma group, IBI, SII, NLR, and lactate levels were significantly higher in patients who developed both mortality and complications (p < 0.05). IBI > 50, SII > 1200, and the combination of NLR > 4 + SII > 1200 were associated with an increased risk of amputation, mortality, and revision, respectively.

IBI, SII, NLR, and lactate levels show a significant association with complications and mortality in thromboembolic and traumatic vascular events. High values of IBI and SII, in particular, emerge as important biomarkers for clinical prognosis. Early evaluation of these parameters may assist in risk stratification and the prediction of potential adverse outcomes.