{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T09:31:24Z","timestamp":1782552684947,"version":"3.54.5"},"reference-count":32,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Respiratory J"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>This retrospective cross\u2010sectional study examined the correlation between Systemic Immune\u2010Inflammation Index (SII) and in\u2010hospital mortality in patients with sepsis combined with chronic obstructive pulmonary disease (COPD) and explored the modifying effect of mechanical ventilation on this relationship.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Logistic regression models were employed to explore the correlation between log SII and in\u2010hospital mortality. The receiver operating characteristic curve and decision curve analysis were used to examine the predictive value of log SII for in\u2010hospital mortality. Generalized linear regression analysis, logistic regression analysis, and restricted cubic spline were used to explore the associations among log SII, in\u2010hospital mortality, and mechanical ventilation states.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1058 patients were enrolled. Log SII was an independent risk factor for in\u2010hospital mortality in patients with sepsis combined with COPD (odds ratios for Model 1, Model 2, Model 3, and Model 4 were 3.116, 2.847, 2.244, and 3.495, respectively; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.005; log SII as an optimal\u2010threshold categorical variable). Additionally, mechanical ventilation was closely related to log SII (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). There was a stronger correlation between log SII and in\u2010hospital mortality of patients who received mechanical ventilation, especially those with invasive mechanical ventilation (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>An elevated SII independently predicts elevated in\u2010hospital mortality risk in sepsis\u2013COPD patients. This association is strongly intensified by mechanical ventilation, particularly the invasive mode. SII serves as a valuable biomarker for risk stratification in this vulnerable population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/crj.70122","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T12:23:02Z","timestamp":1758716582000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Relationship Between Systemic Immune\u2010Inflammation Index and In\u2010Hospital Mortality in Sepsis Combined With Chronic Obstructive Pulmonary Disease Modified by Mechanical Ventilation"],"prefix":"10.1111","volume":"19","author":[{"given":"Ren\u2010wei","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine Zhejiang Tiantai County Hospital of Traditional Chinese Medicine  Zhejiang 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