Systemic Inflammatory Response Index Has a Value for the Early Diagnosis and Short-Term Prognostic Assessment of Severe Pneumonia in the Elderly

Sep 30, 2026

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Systemic inflammatory response index (SIRI) is evaluated for early diagnosis and short-term prognostic assessment of severe pneumonia in elderly patients. A retrospective cohort of 266 elderly pneumonia cases is assigned to severe and non-severe groups based on APACHE-II scores, with correlations assessed against APACHE-II, CRP, and PCT. Patients are followed for 28 days to compare mortality outcomes. Elevated SIRI shows positive associations and strong predictive ability for occurrence and 28-day survival, with APACHE-II and SIRI identified as independent risk factors for short-term death.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Introduction

Rationale for biomarkers and SPM risk in the elderly

Limitations of APACHE-II, CRP, and PCT

Prior evidence and rationale for SIRI

Materials and Methods

Sample size estimation

Participants

Wiley Canadian Respiratory Journal Volume 2026, Article ID 6968736, 8 pages [https://doi.org/10.1155/carj/6968736](https://doi.org/10.1155/carj/6968736) Research Article Systemic Inflammatory Response Index Has a Value for the Early Diagnosis and Short-Term Prognostic Assessment of Severe Pneumonia in the Elderly Xiao Xu, Huajuan Xu, Ming Li, Shuying Yan, and Huilin Chen Intensive Care Unit (ICU), Shanghai Jiangong Hospital, Shanghai 200083, China Correspondence should be addressed to Huilin Chen; [chenhuil888@sina.com](chenhuil888@sina.com) Received 26 December 2024; Revised 11 August 2025; Accepted 29 September 2025 Academic Editor: Alexandru Corlateanu Copyright © 2026 Xiao Xu et al. Canadian Respiratory Journal published by John Wiley & Sons Ltd. Tis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Tis article probed the value of systemic infammatory response index (SIRI) in the early diagnosis and short-term prognostic assessment of severe pneumonia (SPM) in the elderly. First, 266 elderly patients with pneumonia were retrospectively included and allocated into SPM and N-SPM groups as per APACHE-II scores. Correlations of SIRI with APACHE-II scores, CRP, and PCT were analyzed. Patients were followed up for 28 days, and SPM patients were allocated into death and survival groups based on survival status. Te values of SIRI for early diagnosis and short-term prognostic assessment of elderly SPM patients were evaluated. Infuencing factors for short-term death in elderly SPM patients were screened. SIRI levels were high in elderly SPM patients and were positively correlated with APACHE II scores and CRP and PCT levels. SIRI had a high predictive value for the occurrence (AUC 􀂈 0.843) and 28-day survival (AUC 􀂈 0.806) of SPM. High SIRI levels elevated the risk of 28-day mortality in elderly SPM patients. APACHE II scores (HR 􀂈 1.125) and SIRI (HR 􀂈 1.977) were independent risk factors for short-term death in elderly SPM patients. Overall, SIRI has a certain value for the early diagnosis and prognostic assessment of elderly SPM patients. Keywords: early diagnosis; elderly; severe pneumonia; short-term prognosis; systemic infammatory response index 1. Introduction Pneumonia is a prevalent infectious disease of the respiratory system in elderly patients and an important cause of mortality [1] . Elderly patients sufer from low immune function, poor nutrition, and decreased respiratory resistance and are characterized by frequent underlying chronic diseases, such as cardiopulmonary diseases [2] . If the symptoms are atypical or the diagnosis is not standardized and timely, pneumonia is easy to progress to severe pneumonia (SPM) in elderly patients, which dramatically increases morbidity and mortality rates [3] . Some biological indicators ofthe human body have the characteristics of easy and rapid measurement, objectivity, and dynamic monitoring [4] . Terefore, searching for potential indicators that are efective in elderly patients with SPM has a critical clinical value for early disease prediction and prognosis judgment. Te Acute Physiology and Chronic Health Evaluation (APACHE-II) score is a commonly used method for evaluating critical illness and prognosis, which can better refect the damage to the respiratory system, blood system, liver and kidney function, and circulatory system when patients develop a disease but lacks the assessment of the degree of infammatory response [5] . Relevant literature suggests that Gram-negative bacillus infections or co-infections can lead to elevated procalcitonin (PCT) levels in SPM patients, while C-reactive protein (CRP) has been shown to increase with the exacerbation of SPM [6, 7] . In addition, leukocytes, neutrophils, and neutrophil/lymphocyte ratio can be used as predictors for outcomes of SPM patients [8, 9] .

FAQs

What is the study’s primary purpose regarding SIRI?

To determine whether the systemic inflammatory response index can support early diagnosis and short-term prognostic assessment in elderly patients with severe pneumonia.

How were patients allocated into severe and non-severe pneumonia groups?

Patients were retrospectively included and assigned according to APACHE-II scores into severe pneumonia and non-severe groups.

What did the study find about SIRI and short-term outcomes?

High SIRI levels were associated with increased risk of 28-day mortality, and SIRI together with APACHE-II acted as independent risk factors for short-term death.

Sep 30, 2026

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