Search Results (634)

Background/Objectives: This study aimed to investigate the prognostic significance of the triglyceride–glucose index (TGI), triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio, and inflammatory biomarkers in predicting short-term mortality among intensive care unit (ICU) patients with sepsis. Additionally, this study evaluated whether combining these indices with conventional clinical scores improves prognostic accuracy. Methods: This retrospective cohort study included 600 adult ICU patients diagnosed with sepsis according to Sepsis-3 criteria between January 2020 and April 2025. Clinical, biochemical, and hematological data were collected within the first 24 h of ICU admission. Metabolic indices (TGI, TG/HDL-C) and inflammatory markers (neutrophil-to-lymphocyte ratio [NLR], systemic immune-inflammation index [SII], and pan-immune-inflammation value [PIV]) were analyzed. The primary outcome was 28-day mortality. Receiver operating characteristic (ROC) analyses, Kaplan–Meier survival curves, and a multivariable logistic regression model were applied to determine prognostic performance. Results: Non-survivors exhibited significantly higher levels of TGI, TG/HDL-C, NLR, SII, and PIV compared to survivors (all p < 0.001). In ROC analysis, TGI (AUC = 0.75, 95% CI: 0.71–0.79), TG/HDL-C (AUC = 0.72, 95% CI: 0.68–0.76), and PIV (AUC = 0.78, 95% CI: 0.74–0.82) demonstrated good discriminative power for predicting 28-day mortality. Multivariate logistic regression identified TGI > 8.95 (OR = 1.44, 95% CI: 1.19–1.74, p < 0.001), TG/HDL-C > 3.95 (OR = 1.31, 95% CI: 1.08–1.59, p = 0.005), and PIV > 260 (OR = 1.49, 95% CI: 1.22–1.82, p < 0.001) as independent predictors of mortality. Integrating TGI and PIV with the SOFA score improved prognostic performance (ΔAUC = +0.04). Conclusions: Both TGI and TG/HDL-C are independent predictors of short-term mortality in septic ICU patients, reflecting the contribution of metabolic dysregulation to disease severity. The PIV demonstrated comparable predictive ability to conventional severity scores. Combining metabolic and inflammatory biomarkers with established clinical indices may enhance early risk stratification and guide personalized management strategies in sepsis. Full article

Background/Objectives: Early differentiation of odontogenic cervicofacial necrotizing fasciitis (NF) from odontogenic abscess (OA) is clinically challenging yet critical due to the need for urgent surgical and antimicrobial escalation. We evaluated whether a novel C-reactive protein-to-platelet inflammatory index (CPII = CRP/platelets), combined with a symptom-based Symptom Severity (SS) score, improves early discrimination of NF from OA. Methods: This retrospective cohort study included 234 hospitalized patients with cervicofacial odontogenic infections treated between January 2010 and December 2023 (25 NF, 209 OA). Admission clinical variables, SS and SIRS scores, and laboratory parameters were analyzed. CPII and established immunoinflammatory indices (including AISI, SII, NLR, PLR, and LMR) were calculated. Group comparisons were performed using nonparametric and categorical tests. Diagnostic performance was assessed by ROC analysis, and multivariable logistic regression evaluated independent associations with NF. Results: Compared with OA, NF patients were older (median 42 [IQR 35–59] vs. 35 [IQR 26–49] years; p = 0.0098) and more frequently had comorbidities (52% vs. 25.4%; OR 3.19; p = 0.0087). Trismus and dysphagia were more common in NF (84% vs. 60.8%, p = 0.0272; 88% vs. 53.6%, p = 0.0010), with higher SS and SIRS scores (both p < 0.0001). NF was associated with longer hospitalization (median 17 vs. 6 days; p < 0.0001) and more complications (40% vs. 5.7%; OR 10.94; p < 0.0001). CRP was markedly higher in NF (median 287 vs. 111.5 mg/L; p < 0.0001), platelets were lower (median 210 vs. 249 × 10⁹/L; p = 0.0091), and CPII was substantially higher (median 1.23 vs. 0.45; p < 0.0001). AISI did not differ between groups (p = 0.861). ROC analysis demonstrated excellent discrimination for SS score (AUC 0.9328, cut-off 12), CRP (AUC 0.9109, cut-off 221 mg/L), and CPII (AUC 0.9271, cut-off 0.75), whereas AISI showed limited discrimination (AUC 0.5108). In multivariable analysis, both SS score (adjusted OR 2.08 per 1 point) and CPII (adjusted OR 6.87 per 0.5 units) were independently associated with NF; the combined SS + CPII model achieved an AUC of 0.9726. Conclusions: CPII is a simple, admission-available biomarker that differentiates odontogenic cervicofacial NF from OA with excellent accuracy and provides strong complementary value when combined with SS score. AISI, despite prior utility for odontogenic abscess severity assessment, did not discriminate NF from OA in this cohort. Full article

Autoimmune thyroid diseases (AITD) are based on reactivity to thyroid self-antigens, resulting in varying degrees of persistent inflammation and glandular hyperplasia. The aim of this study was to investigate the interplay between angiogenesis, inflammation, and oxidative stress in patients with AITD. The study included patients with AITD, divided into a group with Hashimoto’s thyroiditis (HT) and a group with Graves’ disease (GD), as well as healthy controls. The results showed that subjects with GD had significantly higher concentrations of angiopoietin-2 (Ang-2) compared to those with HT and the healthy controls (p < 0.001). Inflammatory parameters (C-reactive protein (CRP), the systemic inflammatory immune response index (SII), and the CRP/albumin ratio (CRP/alb)) were higher in both AITD groups (p < 0.001). Oxidative stress parameters were more pronounced in AITD, while the activity of antioxidant enzymes was reduced. Ang-2 positively correlated with H₂O₂ (r = 0.394, p = 0.006) and NO (r = 0.519, p = 0.001) in HT, as well as with O₂⁻ (r = 0.232, p = 0.009) and TBARS (r = 0.190, p = 0.038) in GD, while in GD it showed a negative correlation with SOD (r = −0.426, p = 0.012) and CAT (r = −0.534, p = 0.008). Thus, angiogenesis, inflammation, and oxidative stress are interconnected processes in AITD, which may have significance for further understanding of the disease and the development of therapeutic approaches. Full article

Background/Objectives: Calprotectin (CLP), a calcium-binding protein complex released predominantly from neutrophils and monocytes, plays a key role in the inflammatory response. Increased levels of CLP have been reported in various inflammatory and malignant conditions. This study aimed to evaluate serum CLP concentrations and their associations with hematological and biochemical parameters in patients with lung cancer. Methods: This prospective observational study included newly diagnosed lung cancer patients and a healthy control group. Demographic data, routine laboratory parameters, CLP levels, and inflammatory indices including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune–inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune–inflammation value (PIV) were recorded. Comparisons were made between groups and across tumor molecular profile, cancer stages, and metastasis status. Correlation and ROC analyses were performed. Results: Serum CLP levels were significantly higher in the lung cancer group compared with healthy controls (p < 0.001). Among molecular subgroups, patients with positive molecular testing had significantly elevated CLP levels compared with negative and untested groups (p = 0.025). CLP did not differ significantly across cancer stages or metastasis status (p > 0.05). CLP showed a positive correlation with the SIRI (r = 0.323; p = 0.004) and PIV (r = 0.395; p < 0.001). ROC analysis revealed that CLP demonstrated good diagnostic performance for lung cancer, with an AUC of 0.930 (95% CI: 0.849–0.976), sensitivity of 79.5%, and specificity of 92.3%. Among inflammatory indices, PIV (AUC = 0.863) and SIRI (AUC = 0.810) also showed high diagnostic accuracy. Conclusions: CLP levels are significantly elevated in lung cancer and show strong discriminative ability, outperforming commonly used inflammatory indices. Although CLP is not specific to lung cancer, it may serve as a supportive, noninvasive biomarker reflecting inflammatory burden when interpreted alongside clinical evaluation, imaging findings, and other laboratory parameters. Full article

Background: Patients with coexisting lung cancer and COPD are highly susceptible to unplanned readmissions. This study aimed to develop and internally validate a robust predictive nomogram based on the “inflammation-nutrition-tumor” framework to quantify this risk. Methods: A retrospective cohort of 207 clinical episodes from male patients with lung cancer and COPD was analyzed. Participants were categorized into Planned Readmission (PR, n = 165) and Unplanned Readmission (UR, n = 42) groups. Independent risk factors were identified via univariate and multivariable analyses using Generalized Estimating Equations (GEE). A nomogram was subsequently constructed, and its performance was rigorously evaluated using the Area Under the Curve (AUC), calibration plots, and Decision Curve Analysis (DCA). Results: Multivariable GEE analysis demonstrated that the Systemic Immune-Inflammation Index (SII) was a highly significant independent risk factor (OR for a 500-unit increase = 1.490, 95% CI: 1.234–1.798, p < 0.001). Advanced cancer stage (III–IV) was also a significant predictor (OR = 3.590, 95% CI: 1.301–9.909, p = 0.014), while prealbumin (OR = 0.950, 95% CI: 0.896–1.007, p = 0.087) was identified as a key nutritional predictor. The integrated four-variable nomogram (age, cancer stage, SII, prealbumin) demonstrated good discriminative ability with an AUC of 0.809 (95% CI: 0.733–0.885). The calibration plot indicated excellent agreement, and DCA confirmed a substantial clinical net benefit. Conclusions: This SII-based nomogram provides a reliable and practical tool for individualized risk stratification, facilitating targeted clinical interventions to mitigate unplanned readmission rates in this vulnerable population. Full article

In the field of veterinary medicine, hematological indices such as the neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), platelet-to-lymphocyte (PLR), systemic immune–inflammatory index (SII), aggregate systemic inflammation index (AISI), and systemic inflammatory response index (SIRI) are increasingly recognized as cost-effective indicators of systemic inflammatory activity. Despite their diagnostic potential, standardized reference intervals for these metrics remain undefined in clinically healthy feline subjects. Consequently, the primary objective of this investigation was to establish baseline reference ranges for these inflammatory ratios in cats, thereby facilitating more accurate clinical interpretations and diagnostic assessments in feline practice. Clinical records were reviewed retrospectively, and cats showing no abnormalities on physical examination and presenting laboratory values within established reference ranges were included in the analysis. Following the sex-based analysis of 88 samples, the reference intervals were defined as follows: 0.8–7.1 for NLR; 0.1–0.6 for MLR; 22.7–374.6 for PLR, 130–2454 for SII, 39.5–1542.8 for AISI, and 0.2–6.1 for SIRI. Comparison by sex did not demonstrate statistically significant differences in any of the analyzed indices. These findings may offer a significant clinical framework for the interpretation of hematological inflammatory markers in feline patients. Full article

Background: After a failed endoscopic retrograde cholangiopancreatography (ERCP) for malignant biliary obstruction (MBO), second-line drainage is performed with endoscopic ultrasound-guided biliary drainage (EUS-BD) or percutaneous transhepatic biliary drainage (PTBD). We compared their effectiveness, safety, and short-term survival. Methods: We conducted a single-center retrospective cohort of 101 adults with MBO after they had experienced a failed ERCP (EUS-BD n = 37; PTBD n = 64). Allocation was non-randomized and driven by operational availability. Baseline laboratory tests (complete blood count, platelets, and C-reactive protein) and derived indices (neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], lymphocyte-to-monocyte ratio [LMR], systemic immune-inflammation index [SII], systemic inflammation response index [SIRI], neutrophil-to-platelet score [NPS], and lymphocyte-to-CRP ratio [LCR]) were compared. Outcomes that were a technical success include: an early biochemical response (bilirubin reduction), complications (Clavien–Dindo), length of stay (LOS), and overall survival (OS). Between-group comparisons used the two-sided Mann–Whitney U test (continuous) and Fisher’s exact (binary) test. Survival was assessed by the Kaplan–Meier estimator using log-rank testing. To address later adoption of EUS-BD, we also estimated a restricted mean survival time of 180 days (RMST_0–180) with 95% confidence intervals (CIs). Results: Baseline inflammatory markers and composite indices were similar; baseline total bilirubin was higher in PTBD. The technical success was 100% in both groups. Early biochemical response was 86.5% after EUS-BD vs. 78.1% after PTBD (p = 0.43). Any complication occurred in 29.7% vs. 12.5% (p = 0.04); major complications (Clavien–Dindo ≥ III) occurred in 10.8% vs. 0% (p = 0.02), respectively; and the LOS did not differ (p = 0.21). OS favored EUS-BD (median 143 vs. 54 days and log-rank p = 0.012). RMST_0–180 was 111.1 days for EUS-BD vs. 71.4 days for PTBD (difference + 39.6 days; 95% CI 11.3–65.9). Conclusions: After a failed ERCP for MBO, EUS-BD and PTBD achieved universal technical success and similar early biochemical responses, but EUS-BD was associated with higher complication rates and a significantly longer six-month survival. These findings support the individualized selection balancing procedural risk with the anticipated survival benefit and highlight the need for prospective comparative studies. Full article

Background and Objectives: This study aimed to assess the prognostic value of several inflammation-based hematological indices in patients with ischemic and hemorrhagic stroke and to evaluate whether their prognostic significance differs between stroke types. The analyzed indices included the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic inflammatory response index (SIRI), systemic immune-inflammation index (SII), and aggregate index of systemic inflammation (AISI). Materials and Methods: This retrospective cohort study analyzed the medical records of stroke patients admitted to two hospitals in Shymkent, Kazakhstan. Hematological parameters were calculated from routine complete blood counts obtained on the third day of hospitalization. Nonparametric tests, univariable and multivariable logistic regression, and receiver operating characteristic (ROC) analysis were used to evaluate associations between inflammatory indices and in-hospital mortality. Results: A total of 199 patients who met the inclusion criteria were classified into three groups according to in-hospital outcome at discharge: (1) patients discharged alive (favorable outcome), (2) patients who died during hospitalization due to ischemic stroke (unfavorable ischemic stroke), and (3) patients who died during hospitalization due to hemorrhagic stroke (unfavorable hemorrhagic stroke). NLR, SIRI, AISI, and SII values were significantly higher in both unfavorable outcome groups compared with the favorable outcome group (p < 0.001, effect size r > 0.6). No statistically significant differences were observed between unfavorable ischemic and hemorrhagic stroke outcomes. In logistic regression analysis, NLR (OR = 1.65) and SIRI (OR = 2.36) showed the strongest associations with in-hospital mortality. ROC analysis demonstrated good predictive performance, with AUC values of 0.885 for NLR and 0.867 for SIRI. Conclusions: The inflammatory indices evaluated in this study were associated with stroke outcomes regardless of stroke subtype. Among them, SIRI and NLR showed the highest prognostic value. These indices may serve as accessible markers of disease severity but should not be considered independent clinical decision-making tools. Full article

Objective: To investigate the association between inflammatory indices derived from complete blood count, including the systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), and pan-immune inflammation value (PIV), in predicting nausea and vomiting in pregnancy (NVP). Methods: Women diagnosed and treated for NVP at a tertiary care hospital between 2016 and 2021 were retrospectively analyzed. A total of 278 eligible patients with NVP and 278 gestational age-matched healthy pregnant women were included. Patients with NVP were categorized as having mild (n = 58), moderate (n = 140), or severe NVP (n = 80). Patients with moderate and severe NVP, who almost always required hospitalization, were grouped together and assigned to the inpatient treatment group. The groups were then compared. Results: SII and PIV were significantly higher in the NVP group than in the control group (p < 0.001 for both). In addition to SIRI, SII and PIV were also significantly higher in both the moderate NVP and HG groups compared to the mild NVP group (p = 0.017, 0.040, and 0.038, respectively, and p = 0.003, 0.009, and 0.006, respectively). SII, with a cut-off value of >966 × 10³/μL (63.67% sensitivity, 68.35% specificity), showed the best discriminatory performance for predicting NVP (p < 0.001), but there was no significant difference among SII, SIRI, and PIV in predicting the need for hospitalization. Conclusions: Our results show that there may be an association between high SII and PIV and an increased risk of developing NVP. In the future, after sufficient research, among these complete blood count-based inflammatory indices, SII may become an important component of regression models used as a screening tool to predict NVP, particularly in cases requiring inpatient care. Full article

In recent years, the food processing industry in the Gulf Cooperation Council (GCC) has faced increasing pressures to improve operational efficiency while improving its environmental performance. This research examines whether Lean Six Sigma (LSS) methodologies can be used as tools to incorporate sustainability into current operational processes at a date processing facility in Saudi Arabia. In addition to illustrating the ways in which production was improved, this research developed and preliminarily validated a Sustainability Integration Index (SII) framework to measure the contributions of improvement projects to sustainable practices in terms of their impact on the environment, society, and economy. Furthermore, this research examined the role of organizational culture as a moderator of the effectiveness of integrated LSS–sustainability approaches using a Cultural Readiness Assessment Model (CRAM). This research addressed production bottlenecks and aligned production with selected United Nation Sustainable Development Goals (SDGs) using the Define–Measure–Analyze–Improve–Control (DMAIC) methodology. Production bottlenecked in packaging operations resulted in schedule overruns and excessive overtime; therefore, the intervention focused on improving the production process in these areas. There were three distinct improvement streams: demand-based resource leveling, advanced production planning to allow for pull-based flow, and targeted maintenance to raise Overall Equipment Effectiveness (OEE) from 48.2% to 74.6%. Results indicated a 23% increase in daily processing capacity, a 38 min decrease in the average length of time of production closures, and estimated annual cost savings of 940,000 SAR (approximately USD 250,000). The SII framework showed a 21.2% improvement in sustainability scores, with a total composite score improvement from 0.66 to 0.80. Social sustainability had the greatest relative increase (+24.2%). Exploratory correlation analysis found that improvements in cultural maturity and cross-functional collaboration are possible predictors of successful sustainability integration; however, the limitations of the single case study limit the ability to draw causal inferences. The results provide both empirical evidence and possible measurement tools to an under-explored area: the use of LSS in Middle Eastern food processing industries with specific sustainability goals. Validation of the frameworks across different industries will be necessary to establish generalizability. Full article

Objective: Acute exacerbations (AECOPD) are primary determinants of clinical instability in chronic obstructive pulmonary disease (COPD), and the “frequent exacerbator” (≥2/year) phenotype markedly increases morbidity and healthcare utilization. In this study, we evaluated the association between the Systemic Immune-Inflammation Index (SII), calculated from routine hemogram parameters during the stable period, and the occurrence of frequent exacerbations within the subsequent 1 year, and aimed to define a clinically applicable SII threshold (cut-off). Materials and Methods: In this retrospective observational cohort study conducted at a tertiary care center, patients who attended the outpatient clinic between January 2020 and February 2025 and had COPD confirmed by post-bronchodilator spirometric criteria (FEV₁/FVC < 70%) were identified through electronic medical records. The index date was defined as a routine outpatient visit during stable COPD; patients were followed for AECOPD for 365 days after the index date. The stable period was defined as a visit occurring ≥4 weeks after the last exacerbation and without signs of acute infection. Patients with positive COVID-19 PCR results were excluded due to the uncertainty in distinguishing exacerbation from COVID-19. The primary endpoint was the development of frequent exacerbations (≥2 AECOPD) within 365 days. AECOPD was defined as an acute worsening of dyspnea, cough, and/or sputum requiring additional pharmacotherapy (systemic corticosteroids and/or antibiotics). SII, NLR, PLR, LMR, and PPN were calculated using hemogram parameters. Groups (<2 vs. ≥2 exacerbations) were compared; a ROC–Youden analysis was performed to determine cut-offs. After ROC-based dichotomization, univariate and multivariable logistic regression analyses were used to evaluate associations; multicollinearity was assessed using the VIF. To address potential optimism bias, diagnostic performance metrics (AUC, sensitivity, specificity) were internally validated using 1000 stratified bootstrap replicates. Results: A total of 159 patients were included. The cohort was predominantly male (91.2%). Demographic characteristics and most spirometric parameters were similar between groups; a trend toward lower absolute FVC was observed in the ≥2 exacerbation group (p = 0.051). Platelet counts were higher in the ≥2 exacerbation group (p = 0.029). In the ROC analysis, AUC values ranged from 0.505 to 0.591 across indices. For the SII, the AUC was 0.591 (95% CI: 0.500–0.677; p = 0.049), and the optimal cut-off was 1082.79. The LMR cut-off was 1.76; however, the LMR did not demonstrate statistically significant discriminatory performance in the ROC analysis (AUC 0.535; p = 0.448). In univariate analyses, SII > 1082.79 (OR = 3.028, 95% CI: 1.522–6.027; p = 0.002) was associated with frequent exacerbations. In a multivariable logistic regression adjusted for cardiovascular disease and overall comorbidity status, SII > 1082.79 remained independently associated (OR = 3.029, 95% CI: 1.485–6.179; p = 0.002). Other hemogram-derived indices did not retain independent prognostic significance in this outpatient cohort. Conclusion: SII measured during stable COPD was independently associated with frequent exacerbations over the subsequent 1 year. The SII > 1082.79 threshold may offer a practical risk stratification approach to flag “high-risk” patients in outpatient care. However, given the modest discriminative performance and the single-cohort derivation, this cut-off should be considered exploratory despite the use of bootstrap internal validation. Because this was a single-center study with a predominantly male cohort, the generalizability—particularly to female patients and other settings—requires prospective external validation. Full article

Mountainous military heritage represents a distinct form of cultural landscape facing compounding threats from environmental degradation and anthropogenic pressures. Conventional conservation models often adopt fragmented approaches, leading to limited long-term sustainability. This study proposes and empirically validates a novel Tri-Dimensional Symbiosis (TDS) framework integrating historical authenticity, ecological resilience, and community vitality to support more holistic heritage conservation. Employing a mixed-methods design—including GIS-based spatial analysis, multi-criteria assessment, Terrestrial Laser Scanning (TLS), and field surveys across twelve Southern Song Dynasty defense sites in Chongqing, China—the study generates three key findings: (1) Approximately 73% of sites face significant pressure from incompatible development (p < 0.01). (2) At the Duogongcheng pilot site, micro-interventions reduced structural deformation by 41% (from 8.3 mm to 4.9 mm, p < 0.001). (3) Community-cooperative tourism increased local household income by 28.5% (p < 0.01) within one year. The study introduces the Symbiotic Interface Index (SII), a robust quantitative tool (CR = 0.07 < 0.1), to assess and optimize synergies between preservation, ecology, and social participation. This framework bridges disciplinary divides, offering a scalable model to transform military heritage from passive relics into active catalysts for sustainable regional development. These findings contribute actionable, policy-relevant strategies for reconciling heritage conservation with socio-ecological resilience in rapidly urbanizing mountainous regions globally. Full article

The coronavirus disease 2019 (COVID-19) pandemic has had an unprecedented impact on public health. In the present study, we aimed to analyze the association of certain inflammatory biomarkers with severe COVID-19 and to explore the role of diabetes mellitus (DM) and vaccination status in relation to COVID-19 severity, intensive care need and mortality. Associated comorbidities (DM, obesity, cardiovascular, neurological, endocrine, hepatic, renal, pulmonary, rheumatological, psychiatric, hematological diseases, cancer and HIV), as well as inflammatory biomarkers, like ferritin, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), fibrinogen, lactate dehydrogenase (LDH), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were analyzed in 866 subjects, according to vaccination status. In unvaccinated subjects, the highest AUROC curve for severe COVID-19 was recorded for CRP (0.668), and in the vaccinated group, the highest was recorded for SII (0.694). In age- and comorbidity-adjusted analyses, diabetes mellitus was associated with higher odds of severe COVID-19, ICU admission, and mortality among unvaccinated patients. This analysis was not feasible in the vaccinated group because of the very low number of unfavorable outcomes. These findings emphasize the potential role of vaccination in attenuating the excess risk linked to comorbidities—particularly diabetes mellitus—and support the use of accessible inflammatory biomarkers for early risk stratification. The results should be interpreted within the specific epidemiological phases of the pandemic and in the context of the observational study design. Full article

Background/Objectives: Emergency surgery for complicated colon cancer carries high morbidity and mortality, largely driven by systemic inflammation and organ dysfunction. This study aims to investigate the predictive value of preoperative inflammatory biomarkers for postoperative outcomes. Methods: We retrospectively analyzed 219 patients undergoing emergency surgery for complicated colon cancer. Patients were classified as uncomplicated (n = 164) or complicated (Clavien–Dindo ≥ IIIA; n = 55). Preoperative clinical data, comorbidity indices, laboratory values, and inflammatory markers: C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were assessed. Logistic regression and ROC (Receiver Operating Characteristic) curves analyses identified predictors of Clavien Dindo complications graded as IIIA or higher, anastomotic leak (AL), and in-hospital mortality. Results: Most patients included in the study were males (75.02%), with a mean age of 69.63 (±11.54) years. Patients included in the complicated group had higher comorbidity burden, ASA (American Society of Anesthesiologists) grade, rates of diabetes, organ failure, and systemic inflammatory response. All inflammatory biomarkers were significantly elevated in the complicated group (p < 0.001). CRP (>62.8 mg/dL), NLR (>6.89), and PLR (>334.2) showed good discrimination for Clavien Dindo complications graded as IIIA or higher, with AUC (area under curve) ranging from 0.726 to 0.799. A multivariable model including Charlson Comorbidity Index (CCI), CRP, PLR, and diabetes predicted Clavien–Dindo ≥ IIIA complications with excellent accuracy (AUC 0.870). PLR, creatinine, and diabetes independently predicted AL (AUC 0.834). Mortality (20.5%) was strongly associated with peritonitis, CRP, and NLR (AUC 0.891). Conclusions: Preoperative inflammatory biomarkers, combined with comorbidity and renal function, reliably predict adverse outcomes after emergency colon cancer surgery. Multivariate models may be useful for early risk stratification and support individualized perioperative management. Full article

Background and Objectives: Viral meningitis presents significant diagnostic challenges. The aim of this study was to identify predictive factors for meningitis etiology and clinical outcomes. Methods: This prospective, single center, comparative study enrolled patients meeting clinical, biological, and microbiological criteria for bacterial (BM) or viral (VM) meningitis. Serum inflammatory markers, namely the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII), were quantified. In addition, the concentrations of oxidative stress biomarkers, glutathione peroxidase 3 (GPx3) and copper/zinc superoxide dismutase (Cu/Zn SOD), were also determined. Spearman correlation and logistic regression were used to evaluate associations between biomarkers and etiology, while receiver operating characteristic (ROC) curves assessed outcome correlations. Results: VM patients showed a significantly lower NLR (p = 0.007), PLR (p = 0.010), and SII (p = 0.016), with higher GPx3 (p < 0.0001) levels compared with BM patients. Cu/Zn SOD showed no significant difference (p = 0.442) between groups. Multivariate logistic regression identified the SII (OR = 1.015; 95% CI = 1.004–1.026) and GPx3 (OR = 0.847; 95% CI = 0.740–0.970) as etiology predictors. The SII was the strongest predictor of mortality in VM (AUC = 0.833). Conclusions: Serum markers of inflammation, including the systemic immune–inflammation index, along with antioxidant indicators such as GPx3, may serve as valuable additional tools for predicting meningitis etiology and forecasting patient outcomes. Full article