Aggregate Index of Systemic Inflammation: the Strongest Predictor of In-Hospital Venous Thromboembolism Events Among Patients Hospitalized for Trauma or Surgery

Abstract

Background: To investigate the power of inflammation/immune indices in-hospital deep vein thrombosis (DVT) and any venous thromboembolism (VTE) event (VTE: DVT + pulmonary embolism [PE]) that may occur after trauma or surgery and to identify the strongest predictors. Methods: This was a retrospective study conducted between January 2020 and December 2022. A total of 216 patients with suspicion of DVT or PE during their hospital stay for trauma or surgery were included in the study. Monocyte-lymphocyte ratio, neutrophil-lymphocyte ratio, and aggregate index of systemic inflammation (AISI) were calculated. Participants were divided into the following 3 groups: those without DVT or PE (control group, n = 70), only DVT (DVT group, n = 71), and both DVT and PE (VTE group, n = 75). Results:The median D-dimer, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, monocyte-lymphocyte ratio, systemic inflammatory index, systemic inflammation response index, and AISI values of VTE group were significantly higher than both the control and DVT groups (P < 0.001 for all). The DVT group also had significantly higher values for these parameters compared to controls (P < 0.001 for all). All of these indices had significantly high performance to detect DVT or PE (P < 0.001 for all). Despite very high performance (some exceeding D-dimer measurement) detected for all examined parameters, AISI was the best predictor in both DVT and VTE (DVT + PE) prediction (area under receiver operating characteristic curve = 0.995 and 0.959, respectively). Conclusions: These indices, especially AISI, can play a role in the initial screening and risk stratification of patients at high risk of DVT or VTE after surgery or trauma.