{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T02:12:04Z","timestamp":1790907124958,"version":"4.1.0"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":55,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Emerg Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Systemic Immune-Inflammation Index (SII\u2009=\u2009PLT \u00d7 NE# \/ LY#) is a composite haematological biomarker derivable from a routine complete blood count (CBC) that integrates neutrophil, platelet, and lymphocyte counts into a single value reflecting systemic inflammatory status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Studies simultaneously evaluating SII across multiple concurrent outcomes in an unselected ED population remain limited. We aimed to evaluate SII\u2019s independent prognostic value for hospitalisation, ICU admission, clinical deterioration, in-hospital mortality, and 72-hour ED return, and its incremental value over NEWS2, NLR, and PLR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective cohort study of 6,739 adults presenting to a tertiary ED (January 2022\u2013December 2023) with a CBC at presentation. SII, NLR, PLR, and NEWS2 were calculated from admission data. Primary outcome was hospitalisation; secondary outcomes were ICU admission, clinical deterioration, in-hospital mortality, and 72-hour ED return. Multivariable logistic regression and ROC analysis were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median SII was 768.1 (IQR: 442\u20131,532); 22.6% were hospitalised. SII independently predicted hospitalisation (aOR\u2009=\u20091.672, 95% CI: 1.551\u20131.803,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; per one ln-unit increase in SII, equivalent to approximately a 2.7-fold increase in raw SII value); however, standalone discriminative performance was modest (AUC\u2009=\u20090.640) and should not be interpreted as clinically actionable in isolation. The primary clinical contribution was incremental: adding SII to NEWS2 increased the AUC from 0.717 to 0.758 (DeLong\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with both markers retaining independent significance after mutual adjustment. Discriminative performance for secondary outcomes was limited (ICU admission AUC 0.430; clinical deterioration AUC 0.561; 72-hour return AUC 0.581), and SII did not independently predict in-hospital mortality after adjustment (AUC 0.571;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.222).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The principal contribution of SII in this study is its incremental prognostic value when combined with NEWS2, rather than standalone discrimination. SII may serve as a practical adjunct to established early warning scores during ED triage. Prospective multicentre validation is required before clinical implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12873-026-01613-9","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T10:50:25Z","timestamp":1778583025000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prognostic Value of the Systemic Immune-Inflammation Index (SII) for short-term clinical outcomes in the emergency department: a retrospective cohort study"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7089-0000","authenticated-orcid":false,"given":"Mehmet \u015eirin","family":"B\u00fcy\u00fckkaya","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osman","family":"Ta\u015f","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmut","family":"\u015eahin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet","family":"Yorgun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramazan Sami","family":"Akta\u015f","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"issue":"5","key":"1613_CR1","doi-asserted-by":"publisher","first-page":"213","DOI":"10.5694\/j.1326-5377.2006.tb00204.x","volume":"184","author":"DB Richardson","year":"2006","unstructured":"Richardson DB. 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Ethics committee approval was granted by the Van Training and Research Hospital Ethics Committee (Protocol No: GOKAEK\/2026-1-20, 2026). Individual informed consent was waived given the retrospective design and use of anonymised data.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"No artificial intelligence tools were used to generate, analyse, or modify the data, figures, or manuscript text in this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"AI Disclosure"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"189"}}