Predictive Value of Perioperative Systemic Inflammation Response Index Dynamics for Postoperative Pulmonary Infection Following Esophagectomy: A Multicenter Retrospective Cohort Study.

Authors

Congyi Wang, Liwen Zhang, Changxi Zhang, Gang Li, Ruiqin Zhou

Published in

Journal of inflammation research. Volume 19. Pages 616232. Epub Sep 22, 2026.

Abstract

Postoperative Pulmonary Infection (POPI) is a leading cause of morbidity and mortality following esophagectomy. Current static inflammatory markers lack the specificity to distinguish between surgical stress and early infection. This study aims to investigate whether the dynamic perioperative changes in the Systemic Inflammation Response Index (SIRI) can reflect the host's "inflammation-immune" balance and predict the occurrence of POPI.
A two-center retrospective cohort study was conducted on 543 patients undergoing radical esophagectomy between January 2020 and November 2025. The SIRI Ratio was defined as postoperative (≤48h) SIRI divided by preoperative SIRI. Univariate and fully adjusted multivariate logistic regression models were performed. Diagnostic value was evaluated using ROC curve analysis, stratified by Neoadjuvant Chemoimmunotherapy (nICT) status.
The overall incidence of POPI was 29.7% (161/543). Patients with POPI exhibited a significantly lower SIRI Ratio (P = 0.002), indicating a blunted acute inflammatory response. Multivariate analysis identified the SIRI Ratio as an independent protective factor against POPI (OR = 0.98, 95% CI: 0.96-0.99, P = 0.037). Notably, a significant interaction was observed between nICT and the SIRI Ratio (P for interaction = 0.004). The SIRI Ratio showed better discrimination in the nICT-naïve subgroup (AUC = 0.776) but its diagnostic value was compromised in the nICT subgroup (AUC = 0.585).
Perioperative changes in SIRI were associated with POPI. The SIRI Ratio showed moderate discrimination overall, with better performance in patients who had not received nICT than in those who had.

PMID:
42801145
Bibliographic data and abstract were imported from PubMed on 27 Sep 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.