Search Results (825)

Background/Objectives: Early identification of ST-segment elevation myocardial infarction (STEMI) at first medical contact remains challenging, as high-sensitivity troponin T may be insufficiently sensitive during the initial phase of myocardial injury. Readily available complete blood count (CBC)-derived inflammatory indices may provide complementary early diagnostic signals. This study aimed to evaluate whether baseline CBC-derived inflammatory indices differ between STEMI and NSTEMI and whether they provide adjunctive discriminatory information at presentation (0 h) in patients with acute coronary syndrome (ACS). Methods: A 12-lead electrocardiogram (ECG), high-sensitivity troponin T, and CBC were obtained at presentation from 252 patients with ACS (195 STEMI and 57 NSTEMI). Diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis and 2 × 2 contingency tables to determine the area under the curve (AUC), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and likelihood ratios. Results: High-sensitivity troponin T demonstrated the highest specificity (84.44%) and PPV (92.93%), supporting its role as a confirmatory biomarker; however, its low sensitivity (50.83%) and NPV (29.92%) may reduce its utility during early assessment. In contrast, WBC and neutrophil counts demonstrated relatively favorable discriminatory performance at presentation (AUC > 0.72; Youden’s index > 0.40). Among composite indices, NLPR demonstrated the highest sensitivity (88.66%) and NPV (53.19%), along with the lowest negative likelihood ratio (0.25), suggesting potential adjunctive value during early assessment. NLR, SII, SIRI, and adjusted NLR showed moderate performance, with aNLR providing a balanced sensitivity (67.01%) and specificity (74.55%). Conclusions: CBC-derived inflammatory indices, particularly neutrophil-based markers such as NLPR, may provide adjunctive discriminatory information during the early assessment of patients with ACS, particularly at first medical contact when baseline hs-Troponin T sensitivity may still be limited. Full article

Background: The immune mechanism of diabetic kidney disease (DKD) has not yet been fully elucidated. This study aimed to characterize circulating lymphocyte subsets in patients with type 2 diabetes mellitus (T2DM), with a particular focus on DKD-related immune alterations and prognosis. Methods: Circulating T cells, B cells and NK cells were identified by flow cytometry. The primary endpoint was all-cause mortality, and overall survival was defined as the time from enrollment to death from any cause or last follow-up. Associations between lymphocyte subsets, inflammatory indices and renal function parameters were analyzed. Cox regression was used to identify factors associated with overall survival in patients with DKD and in the whole T2DM cohort. A prognostic nomogram was developed in the whole T2DM cohort to estimate 1-, 2-, 3-, and 5-year overall survival (OS) probabilities. Model performance was evaluated using the concordance index (C-index), calibration curves, receiver operating characteristic (ROC) curves, and decision curve analysis (DCA). Mendelian randomization (MR) was performed as a further exploratory analysis to assess whether immune-related traits were genetically associated with DKD susceptibility, with inverse variance weighting (IVW) as the primary analytical method. Results: In total, 74 T2DM patients were divided into DKD (stage 3–4 of chronic kidney disease) and non-DKD groups. Median follow-up duration was 34.6 months. DKD patients exhibited elevated levels of NK cells, the monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR). In patients with DKD, higher PLR and serum creatinine (SCr) were associated with poorer overall survival, whereas CD4⁺CD25⁺ T cell frequency was not significant after adjustment. In the whole T2DM cohort, higher frequency of circulating CD4⁺CD25⁺ T cells were associated with improved survival (HR 0.920, 95% CI 0.858–0.986, p = 0.019), whereas elevated PLR and SCr were linked to poorer outcomes. The exploratory nomogram incorporating CD4⁺CD25⁺ T cells, PLR, and SCr, showed acceptable internal performance in this cohort. As a separate exploratory analysis, MR suggested that genetically proxied CD4 expression on activated CD4 regulatory T cells was associated with a lower risk of DKD. Conclusions: DKD was associated with higher mortality and elevated MLR-, NLR-, PLR-, and NK cell levels in patients with T2DM. In patients with DKD, PLR and SCr were associated with overall survival, supporting the prognostic relevance of systemic inflammation and renal dysfunction. Individual lymphocyte subsets were not independently associated with survival in the DKD cohort after adjustment, whereas CD4⁺CD25⁺ T cell frequency provided additional prognostic information in the whole extended T2DM cohort analysis. Further validation is warranted. Full article

Background: Early identification of bacteremia in immunosuppressed cancer patients remains difficult, especially in neutropenia. This study evaluated the diagnostic accuracy of NLR, PLR, and NLPR for identifying bacteremia and sepsis in patients undergoing blood culture episode. Methods: We conducted a retrospective diagnostic accuracy study at a tertiary oncology center between January 2023 and December 2024. All bacteremia identified were included as cases. Culture-negative episodes were subsequently sampled as controls using a frequency-matching strategy. Hematological parameters were obtained within ±24 h of first blood culture episode. Diagnostic performance was assessed using ROC curve analysis and multivariable logistic regression. Results: Of 369 screened episodes, 337 from 323 unique patients were included after excluding 31 records. NLPR showed the highest accuracy for bacteremia (AUC 0.730; 95% CI 0.671–0.788). The optimal cut-off was 0.038 (sensitivity 69.2%, specificity 72.3%) and remained consistent after excluding episodes with antibiotic therapy (AUC 0.768), corticosteroids (AUC 0.708), or growth factor use (AUC 0.718). In severe neutropenia, NLPR showed the highest accuracy (AUC 0.887; 95% CI 0.797–0.978). In multivariable analysis (n = 304), NLPR remained independently associated with bacteremia (p < 0.001), with good model discrimination (AUC 0.815; 95% CI 0.763–0.866). Diagnostic performance for sepsis was lower and not statistically significant. Conclusions: These findings suggest that NLPR may represent a simple, inexpensive, widely accessible adjunctive biomarker to support early bacteremia risk stratification in immunosuppressed cancer patients, particularly in patients with severe neutropenia. Although its overall discrimination was comparable to isolated lymphocyte count, NLPR may provide clinically relevant contextual information by integrating multiple dimensions of immune dysregulation. Further prospective multicenter validation is warranted. Full article

Background/Objectives: Vaginal cuff hematoma is a recognized complication following hysterectomy, with a subset of patients requiring invasive intervention. No reliable bedside biomarker currently exists to identify at admission patients likely to fail conservative management. This study aimed to evaluate the incidence and clinical characteristics of symptomatic vaginal cuff hematoma across all hysterectomy approaches, and to assess the predictive performance of the CALLY index (CRP-albumin-lymphocyte index), a composite marker of inflammatory burden, immune function, and nutritional status, alongside the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) for identifying patients requiring interventional management. Methods: This retrospective cohort study included 61 patients with symptomatic vaginal cuff hematoma following hysterectomy in a major tertiary referral center (November 2022–July 2025). Patients were divided into conservative (n = 38) and interventional (n = 23) management groups. The CALLY index was calculated as [Albumin (g/dL) × Lymphocyte (×10⁹/L)] ÷ [CRP (mg/L) × 10⁻²]. Receiver operating characteristic (ROC) curve analysis with the DeLong method was used to compare predictive performance. Results: The overall incidence of symptomatic vaginal cuff hematoma was 1.9% (73/3852 hysterectomies), with the highest rate following vaginal hysterectomy (3.32%) and the lowest after robotic hysterectomy (0.74%). Interventional management was required in 37.7% of patients. The interventional group had significantly higher CRP (192 vs. 62 mg/L, p < 0.001), NLR (7.53 vs. 4.17, p < 0.001), and SII (2308 vs. 1207, p < 0.001), and significantly lower CALLY index values (2.00 vs. 9.80, p < 0.001). The CALLY index demonstrated the highest predictive performance (AUC = 0.863, 95% CI: 0.762–0.964), outperforming SII (AUC = 0.801), NLR (AUC = 0.789), and PLR (AUC = 0.654). At the optimal cutoff of ≤2.89, the CALLY index yielded a sensitivity of 65.2% and a specificity of 92.1%. Conclusions: The CALLY index is a simple, routinely available composite biomarker that may help identify patients at higher risk for interventional management in symptomatic vaginal cuff hematoma. Its incorporation into postoperative assessment may improve risk stratification and support timely clinical decision-making. Full article

Background/Objectives: Early childhood caries (ECC) is a chronic inflammatory condition that may impose a systemic burden in pediatric patients. This study aimed to evaluate the association between dental caries severity, classified by dmft (decayed, missing, and filled teeth for primary dentition) scores, and preoperative systemic inflammatory markers derived from routine complete blood counts (CBC). Methods: This retrospective study included 159 children aged 36–71 months. Participants were categorized into three groups based on dmft scores: low (0–3), medium (4–8), and high (≥9). Hematological parameters and inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII), were analyzed using one-way ANOVA with post hoc comparisons. Results: Significant differences were observed among dmft groups for neutrophil and lymphocyte percentages (p = 0.026 and p = 0.027) and lymphocyte count (p = 0.020). The medium severity group demonstrated higher neutrophil levels and lower lymphocyte values compared to the high severity group (p < 0.05). Although overall group differences for NLR and SII were not statistically significant (p > 0.05), both markers were significantly higher in the medium group than in the high group (p < 0.05). No significant differences were found in hemoglobin, RDW, or platelet parameters. Conclusions: A non-linear trend was observed, with relatively elevated inflammatory markers in the moderate dmft group. These findings suggest that systemic inflammation in ECC is more closely related to disease characteristics than to caries burden alone. CBC-derived parameters may provide supportive but limited value for assessing systemic inflammatory status in pediatric dental patients. Full article

Background/Objectives: This study aimed to investigate the prognostic value of preoperative systemic inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune–inflammation index (SII), and prognostic nutritional index (PNI), in conjunction with tumor markers and histopathological parameters, on overall survival (OS) and disease-free survival (DFS) in patients with endometrioid adenocarcinoma. Systemic inflammation has been increasingly implicated in tumor progression, and inflammation-based indices derived from routine blood tests offer a practical approach for preoperative risk assessment. Methods: A total of 155 patients diagnosed with endometrioid adenocarcinoma between 2016 and 2025 were retrospectively analyzed. The NLR, PLR, SII, and PNI were calculated from preoperative complete blood count and biochemical data. Associations with histopathological parameters, including FIGO grade, myometrial invasion, cervical stromal involvement, lymphovascular invasion, and lymph node metastasis, were evaluated. Survival analyses were performed using the Kaplan–Meier method and Cox proportional hazards regression models. Results: Patients with cervical stromal involvement had significantly higher NLR values (p = 0.028) and lower lymphocyte counts (p = 0.032). Additionally, lower albumin and PNI levels were observed in patients with cervical stromal involvement (p = 0.034 and p = 0.031, respectively). Multivariate Cox regression analysis identified advanced age (HR: 1.09, p < 0.001), subtotal hysterectomy (HR: 3.76, p = 0.006), lymph node metastasis (HR: 4.78, p = 0.020), elevated CRP levels (HR: 1.05, p = 0.004), high SII (HR: 1.002, p = 0.037), and increased CA 15-3 levels (HR: 1.04, p < 0.001) as independent predictors of poor OS. CA-125 level was an independent risk factor for DFS (p = 0.031). Conclusions: Systemic inflammatory markers, particularly SII and NLR, may serve as useful prognostic indicators for endometrioid adenocarcinoma. Their association with survival outcomes and local tumor extension highlights their potential clinical value in preoperative risk stratification and individualized treatment planning. Future prospective studies integrating these markers with molecular classification data are required. Full article

Background and Objectives: The primary objective of this study was to elucidate the diagnostic significance of systemic inflammatory indices and C1q/TNF-related proteins (CTRP3 and CTRP5) in acute facial paralysis, with a focus on identifying independent metabolic and immunological predictors. Materials and Methods: This retrospective analysis included 64 individuals (25 patients with acute facial paralysis and 39 healthy controls). Complete blood count–derived indices (neutrophil-to-lymphocyte ratio [NLR] and platelet-to-lymphocyte ratio [PLR]), serum albumin, and serum CTRP3/CTRP5 levels (ELISA) were compared between groups. Independent predictors were assessed using binary logistic regression, and discriminative performance was evaluated by ROC analysis. Results: Compared with controls, the facial paralysis group showed lower albumin (p < 0.001) and lymphocyte counts (p = 0.010), higher neutrophil counts (p = 0.012), and elevated NLR (p < 0.001) and PLR (p = 0.026). CTRP3 levels were significantly lower in patients (p = 0.002), whereas CTRP5 did not differ between groups (p = 0.853). In a parsimonious multivariable logistic regression model adjusted for NLR and CTRP3, NLR remained the only independent predictor (OR = 2.54, p = 0.004). ROC analysis showed an AUC of 0.753 for NLR and a raw AUC of 0.265 for CTRP3 (p = 0.002). An AUC significantly below 0.5 indicates that lower CTRP3 levels are associated with facial paralysis, which is statistically equivalent to an inverse predictor. Conclusions: Acute facial paralysis is characterized by a systemic inflammatory shift and reduced CTRP3 levels. Given the modest sample size, these findings should be strictly considered hypothesis-generating, suggesting that the depletion of anti-inflammatory defenses and increased inflammatory burden may play a role in the acute phase. Full article

Objectives: Although obesity is known to cause low-grade chronic inflammation, the extent to which body mass index (BMI) reflects this remains questionable. To investigate this, we classified a national obesity cohort by BMI and evaluated its association with complete blood count (CBC)-derived systemic inflammatory indices. Methods: This retrospective, multi-center study included 6499 adults from the OBREDI-TR cohort with available laboratory data. Patients were categorized by BMI into Class I (30.0–34.9 kg/m², n = 2751), Class II (35.0–39.9 kg/m², n = 1804), and Class III (≥40.0 kg/m², n = 1944) obesity. We compared demographic, clinical, and laboratory parameters, especially in terms of CBC-derived inflammation parameters: neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI). Results: The Class III group was younger (42.73 ± 13.21 vs. 45.14 ± 14.12 in Class I) and predominantly female (p < 0.001 for both). None of the evaluated inflammatory indices showed significant differences across the groups (NLR, p = 0.435; PLR, p = 0.141; LMR, p = 0.520; SII, p = 0.326; SIRI, p = 0.459). Interestingly, hypertension was less common in the Class III obesity group (49.0% vs. 53.5% in Class I, p = 0.009). Conclusions: The failure of increasing inflammatory indices to parallel BMI, creating a “ceiling effect,” reflects the inadequacy of BMI in determining inflammatory burden. Evaluating the inflammatory burden of obesity through visceral adiposity and metabolic phenotyping (metabolically healthy (MHO) vs. metabolically unhealthy obesity (MUO) rather than BMI will provide a more accurate basis for objective clinical evaluation and personalized treatment. Full article

Background and Objectives: We aimed to determine whether preoperative systemic inflammatory markers derived from complete blood count differ between patients with intradural spinal tumors and healthy controls, and whether any such difference varies by pathological subtype or motor deficit status. Materials and Methods: Sixty-four patients who underwent surgery for histopathologically confirmed intradural spinal tumors between 2015 and 2023 were enrolled alongside 64 age- and sex-matched healthy controls. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), pan-immune-inflammation value (PIV), and red cell distribution width (RDW) were calculated from preoperative complete blood count results. Comparisons were performed at the patient–control level and stratified by pathological diagnosis (meningioma, schwannoma, ependymoma, other) and motor deficit status. Results: NLR (median 2.47 vs. 2.06; p < 0.001), PLR (157.1 vs. 121.0; p < 0.001), SII (706.1 vs. 595.0; p = 0.003), and PIV (404.2 vs. 287.0; p < 0.001) were all significantly elevated in the tumor group, while LMR was significantly lower (3.66 vs. 4.34; p < 0.001). RDW did not differ between groups (p = 0.420). Stratification by pathological subgroup and motor deficit status revealed no significant differences in any marker. Conclusion: Intradural spinal tumors—including the predominantly benign cases that made up most of this cohort—are accompanied by a detectable preoperative shift in systemic inflammatory markers, one that appears independent of tumor histology and neurological presentation. These findings demonstrate a measurable systemic inflammatory response in patients with intradural spinal tumors. However, the absence of differences across pathological subtypes and motor deficit status suggests that these markers reflect a generalized host response rather than tumor-specific characteristics, and their role in clinical decision-making remains to be clarified. Full article

Background: Patients with COVID-19 often develop COVID-19-Associated Coagulopathy (CAC)—an imbalance between procoagulant and anticoagulant pathways resulting from the uncontrolled inflammatory response triggered by SARS-CoV-2 infection. This study aims to investigate the impact of a hematological and inflammatory parameter—the platelet-to-lymphocyte ratio (PLR)—on the severity and mortality of COVID-19. Methods: We conducted a comprehensive search of the PubMed database and yielded 75 articles published in the period of 2020–2025, of which 20 studies that evaluated the prognostic value of PLR on hospital admission in COVID-19 patients were included. The review particularly focuses on ROC analyses and reported AUC values. Results: A total of 20 studies were analyzed, including 13 studies assessing disease severity and 14 studies evaluating mortality. Higher PLR values have been observed in patients with a more severe course of COVID-19 compared to those with milder disease, and in non-survivors compared to survivors. However, the literature shows inconsistency regarding the diagnostic utility of PLR based on ROC curve analysis. The reported AUC values ranged from 0.559 to 0.811 for disease severity differentiation and from 0.474 to 0.758 for mortality, which may be related to the heterogeneity of the study populations included in the analysis. Conclusions: PLR may not serve as a direct bridge between inflammation and coagulation in COVID-19-Associated Coagulopathy, but it is indirectly linked to disease severity and mortality, as it reflects changes in both platelet and lymphocyte counts. It is a complementary marker that may assist clinicians in assessing COVID-19 patients but still requires further investigation. Full article

Objective: Peripheral arterial occlusive disease (PAOD) is characterized by impaired tissue perfusion, chronic ischemia, and increased platelet reactivity. Hyperbaric oxygen therapy (HBOT) is used as adjunctive treatment in advanced PAOD, but its effect on platelet function remains insufficiently studied. This study examined the association between HBOT and platelet aggregation. Methods: This prospective observational study included 90 patients with Fontaine stage IV PAOD and chronic ulceration, assigned to an HBOT group (n = 60) or waiting-list control group (n = 30). Patients were predominantly male; mean age was 66.82 ± 9.42 years in the study group and 63.00 ± 8.31 years in controls, and diabetes mellitus was present in 55.0% and 63.3%, respectively. Prior revascularization included open surgery in 33.3% and 30.0%, endovascular treatment in 36.7% and 43.3%, and no option for revascularization in 30.0% and 26.7%, respectively. HBOT was administered over 4 weeks (20 sessions, 2.0–2.5 ATA). Platelet aggregation was measured by impedance aggregometry using arachidonic-acid-induced aggregation (ASPI), adenosine-diphosphate-induced aggregation (ADP), and thrombin-receptor-activating peptide-induced aggregation (TRAP) agonists. Changes were analyzed using generalized estimating equation models adjusted for antiplatelet therapy, diabetes mellitus, smoking, and C-reactive protein (CRP). Results: Significant group × time interactions were observed for all platelet activation pathways, indicating greater reductions in the HBOT group than controls: ASPI (β = −290.5; p < 0.001), ADP (β = −243.6; p < 0.001), and TRAP (β = −330.9; p < 0.001). No significant change was observed in controls. HBOT was associated with reduced pain intensity, while CRP and platelet-to-lymphocyte ratio (PLR) remained stable. Ulcer size showed no significant change after 4 weeks. Conclusions: In patients with PAOD, HBOT was associated with reduced platelet reactivity independent of antiplatelet therapy. Further randomized studies are needed to determine its clinical significance. Full article

Objective: Due to the varied clinical manifestations of acute pancreatitis (AP), prompt identification of patients predisposed to extended hospitalization is essential for efficient resource allocation. This study assessed the predictive efficacy of inflammatory and immunonutritional ratios—namely, C-reactive protein/albumin ratio (CAR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and hemoglobin, albumin, lymphocyte, and platelet score (HALP)—in predicting hospitalizations lasting more than 7 days. Methods: A retrospective cohort analysis was performed on 306 patients treated at a tertiary center from June 2020 to June 2025. We used Mann–Whitney U tests, ROC analysis, and multivariate logistic regression models to evaluate the relationship between admission laboratory-derived ratios and length of stay. Results: In total, 27.5% (n = 84) of the cohort experienced prolonged hospitalization. Individual markers exhibited moderate discrimination; however, procalcitonin and CAR displayed high negative predictive values (>85%), demonstrating clinical utility in excluding prolonged hospital stays. Multivariate analysis revealed advanced age (p < 0.001) and increased CAR (p < 0.001) as the most significant independent predictors. On the other hand, the HALP score was much lower in the group that stayed longer, but it was not an independent predictor in the multivariate model. Conclusions: Older age and a higher CAR are both independent factors that can predict longer hospital stays in AP. The high negative predictive value of CAR is important because it represents a reliable way to exclude prolonged hospitalization. Low CAR levels at admission may help clinicians identify patients eligible for early discharge, thereby optimizing bed management. Full article

Pre-eclampsia, a major obstetric syndrome with an estimated global incidence of 2–8% of all pregnancies, ranks among the foremost causes of adverse maternal and perinatal outcomes worldwide. The Systemic Immune-Inflammation Index (SII)—derived as the product of platelet and neutrophil counts divided by the lymphocyte count—is a composite hematological parameter first established in oncological research that simultaneously captures neutrophil activation, lymphocyte dysfunction, and platelet alterations—three immunohematological disturbances implicated in pre-eclampsia pathophysiology. This narrative review synthesizes the current evidence regarding SII in pre-eclampsia, examining the biological rationale, clinical study findings, comparative performance against established inflammatory biomarkers, practical advantages, and limitations. A comprehensive literature search encompassing PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar was conducted, covering all available records up to January 2026. The available data reveal substantial heterogeneity in both the direction of association (elevated versus paradoxically decreased SII in pre-eclampsia) and diagnostic performance across populations. While some studies report significantly elevated first-trimester SII values in women who subsequently develop pre-eclampsia, others demonstrate lower values or no significant predictive capacity. The only available meta-analysis reported non-significant pooled results for the pre-eclampsia-specific subgroup. Although SII’s derivation from routine complete blood count testing presents the advantages of cost-effectiveness and universal accessibility, methodological limitations—including retrospective study designs, the absence of standardized thresholds, the inconsistent discriminatory performance, and the conflicting directionality of association—preclude clinical implementation at present. Integration within multiparametric prediction models may optimize SII’s clinical utility. Future research should prioritize prospective validation studies across diverse populations, mechanistic investigations, and randomized controlled trials to establish evidence-based clinical translation. Full article

Background: This study investigated the role of lymphocyte-based inflammatory indices (LBIIs) in predicting severe coronary artery disease (CAD) in patients undergoing coronary angiography (CAG) for unstable angina pectoris (USAP). Methods: Records of patients who underwent CAG between January 2023 and December 2024 were retrospectively reviewed. The patients were divided into two groups based on coronary artery stenosis severity: non-severe CAD (<70% stenosis) and severe CAD (≥70% stenosis). Demographic data, risk factors, and complete blood count parameters were recorded. Six LBIIs were calculated: the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), Systemic Immune–Inflammation Index (SII), Systemic Inflammatory Response Index (SIRI), and Systemic Immune–Inflammatory Response Index (SIIRI). Diagnostic performance was evaluated using logistic regression and ROC curve analyses. Results: Out of 505 patients, 234 (46.3%) had severe CAD. Among the six LBIIs, only the SII differed significantly between groups in univariate analysis and showed moderate discrimination in the ROC analysis (AUC 0.71; 95% CI 0.661–0.762; p < 0.001; sensitivity 76.2%; specificity 56.1%). However, the SII was not an independent predictor in the multivariate analysis. Conclusions: LBIIs (NLR, MLR, PLR, SII, SIRI, and SIIRI) do not provide a clinically significant and independent contribution to predicting severe CAD in USAP patients undergoing CAG. Although the SII performed moderately well in the univariate analysis, it lost independence in the multivariate analysis and is thus not suitable for use as a standalone marker in clinical decision-making. Full article

Objectives: This study investigated the associations of biochemical and body water distribution parameters with dengue status, as well as their discriminatory ability, among hospitalized adults with febrile illnesses and evaluated whether dynamic changes in body water volumes were associated with length of hospital stay (LOS) in dengue patients. Methods: A prospective observational cohort study was conducted at a tertiary care hospital involving 186 hospitalized adults (age ≥ 18 years) with fever onset ≤ 5 days and suspected dengue. Body water parameters were assessed by bioelectrical impedance analysis (BIA) using the InBody S10 body composition analyzer at admission (T1), defervescence (T2), and discharge (T3) in dengue patients and at admission only in other febrile illness (OFI) cases. Laboratory data and LOS were retrieved from the hospital information system. Linear and logistic regression models were used to examine the associations and interactions. Discriminative performance was assessed using a receiver operating characteristic (ROC) curve analysis. Results: The proportion of dengue cases was 55.9% (n = 104). Higher levels of lymphocytes, hematocrit, hemoglobin, AST, and ALT were associated with an increased likelihood of dengue, whereas elevated WBC counts, neutrophils, platelets, CRP, sodium, chloride, and the extracellular water-to-total body water ratio (ECW/TBW) were associated with a reduced likelihood of dengue. ROC analysis indicated that WBC showed the best diagnostic performance. In dengue patients, a greater increase in ECW volume from admission to defervescence was associated with a longer LOS in males, and ratio-based body water parameters showed longitudinal variation across dengue phases. Conclusions: Several hematologic, biochemical, and BIA-derived body water parameters were associated with dengue status. Among dengue patients, dynamic ECW changes were associated with longer LOS in males, and ratio-based fluid indices were more sensitive than absolute water volumes in reflecting fluid redistribution throughout the dengue course. Full article