Predictive Value of the Systemic Immune-Inflammation Index and CRUSADE Score for Bleeding and Mortality in Older Patients With Acute Coronary Syndrome
ABSTRACT
Background
There are currently no adequate studies evaluating the relationship between the systemic immune-inflammation index (SII) and bleeding in older patients presenting with acute coronary syndrome (ACS). This study investigated the predictive value of SII for in-hospital bleeding and the CRUSADE Bleeding Score (CBS) for long-term mortality in older patients with ACS.
Methods
The study included 367 older patients, aged 75 years and above, admitted with ACS between April 2015 and January 2023. Predictors of in-hospital bleeding were determined using multivariate logistic regression analysis. Survival curves were generated using the Kaplan-Meier method.
Results
The patients' median age was 81 (77–85), and 179 (48.8%) were male. The median follow-up was 24 months (Q1–Q3: 5–47, maximum: 96). In-hospital bleeding was significantly elevated in patients in the high SII group (p = 0.005); all long-term mortality was significantly increased in those with a high CBS (p = 0.001). Multivariate logistic regression analysis revealed that the estimated glomerular filtration rate (eGFR) (odds ratio [OR]: 0.980, 95% confidence interval [CI]: 0.964–0.995, p = 0.009) and SII (OR: 1.001, 95% CI: 1.001–1.003, p = 0.001) were independent predictors of in-hospital bleeding. Kaplan−Meier analysis confirmed that the all-cause mortality rate in patients with high CBS (≥ 46) was significantly higher than that of patients with low CBS (Long Rank: 37.12, p = 0.001).
Conclusion
A high SII was an independent predictor of in-hospital bleeding, and a high CBS at admission was associated with increased long-term mortality in older patients with ACS.
Conflicts of Interest
The authors declare no conflicts of interest.
Open Research
Data Availability Statement
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
