{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T17:48:34Z","timestamp":1790963314833,"version":"4.1.0"},"reference-count":35,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T00:00:00Z","timestamp":1741824000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Vascular"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lower extremity peripheral arterial disease (LEAD) is characterized by the narrowing and occlusion of arteries in the lower extremities. The most severe form of LEAD is chronic limb-threatening ischemia (CLTI), which carries a poorer prognosis for major amputation. The systemic immune-inflammation index (SII) is an index developed to simultaneously reflect the inflammatory and immunothrombosis status of patients, based on platelet counts and the neutrophil-to-lymphocyte ratio.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Our study aimed to investigate the relationship between elevated SII and major limb amputation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      The study included 140 patients with foot wounds (Rutherford 5 or 6) due to LEAD who were scheduled for endovascular intervention between 2018 and 2023. Major amputation was required in 27 patients (19.2%). The neutrophil-to-lymphocyte ratio (2.1\/2.8\/3.8 vs 3.8\/6.6\/9.3,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; .001), platelet-to-lymphocyte ratio (103.8\/128.8\/162.9 vs 132.8\/212.3\/314.6,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; .001), and SII (527\/720\/1055.5 vs 1108\/1951\/3807,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; .001) were higher in the major amputation group. ROC curve analysis determined that the optimal cut-off value for SII to predict major amputation in LEAD patients was 1018, with a sensitivity and specificity of 81% and 73%, respectively (AUC: 0.84, 95% CI: 0.74\u20130.92,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; .001). Logistic regression analysis showed that high SII (OR = 1.001, 95% CI = 1\u20131.001,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = .009) was identified as an independent predictor of major amputation in LEAD patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study establishes that a high SII value is associated with major amputation in LEAD patients with foot wounds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>SII is a valuable and straightforward parameter for predicting major amputation risk and guiding treatment decisions in LEAD patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17085381251327174","type":"journal-article","created":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T11:15:58Z","timestamp":1741864558000},"page":"232-239","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["The systemic immune-inflammation index is an independent predictive factor in predicting major amputation in chronic limb-threatening ischemia"],"prefix":"10.1177","volume":"34","author":[{"given":"Ahmet Can","family":"\u00c7akmak","sequence":"first","affiliation":[{"name":"Sakarya University Education and Research Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet B\u00fclent","family":"Vatan","sequence":"additional","affiliation":[{"name":"University of Sakarya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Betul","family":"Sar\u0131b\u0131y\u0131k \u00c7akmak","sequence":"additional","affiliation":[{"name":"University of Sakarya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alper","family":"Erkin","sequence":"additional","affiliation":[{"name":"University of Sakarya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ersan","family":"Tatl\u0131","sequence":"additional","affiliation":[{"name":"Focus T\u0131p Merkezi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8295-9837","authenticated-orcid":false,"given":"Ibrahim","family":"Kocayigit","sequence":"additional","affiliation":[{"name":"University of Sakarya"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,3,13]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001005"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00772-018-0380-1"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2019.02.016"},{"key":"e_1_3_3_5_2","first-page":"80","article-title":"Critical limb ischemia: a threat to life and limb. 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The effect of the systemic immune\u2013inflammatory index on the no-reflow phenomenon in patients undergoing saphenous vein intervention. Adv Interv Cardiol 2024; 20(2): 148\u2013156.","journal-title":"Adv Interv Cardiol"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.3390\/medicina57060588"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2013.08.003"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(97)70045-4"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2011.08.014"},{"key":"e_1_3_3_22_2","first-page":"152660282412485","article-title":"Outcomes for patients with chronic limb-threatening ischemia after direct and indirect endovascular and surgical revascularization: a meta-analysis and systematic review","volume":"30","author":"Tarricone A","year":"2024","unstructured":"Tarricone A, Gee A, de la Mata K, et al. Outcomes for patients with chronic limb-threatening ischemia after direct and indirect endovascular and surgical revascularization: a meta-analysis and systematic review. 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