Relationship between systemic immune-inflammation index and risk of mortality among pneumonia patients: a systematic review with meta-analysis
Abstract
Background The association of systemic immune-inflammation index (SII) with mortality risk in patients with pneumonia remains unclear now. This meta-analysis aimed to identify the relationship between SII and risk of mortality among pneumonia patients. Methods Several databases were searched up to September 10, 2025. Odds ratios (ORs) and 95% confidence intervals (CIs) were combined and subgroup analyses by the study design (single-center vs. multi-center), location of occurrence [community-acquired pneumonia (CAP) vs. hospital acquired pneumonia (HAP)], etiology (viral vs. bacterial), severity of pneumonia (severe pneumonia), patient care setting (ward vs. intensive care unit), grouping method by SII (binary vs. continuous) and follow-up period (≤30 vs. >30 days) were performed. Results Eleven studies with 2,841 cases were included with the mortality rate of 21.1%. Pooled results demonstrated that elevated SII was related to increased risk of mortality (OR =1.02, 95% CI: 1.00–1.05, P<0.001). Then subgroup analysis by the location of occurrence and etiology showed that the association between SII and risk of mortality was more significant among patients with CAP and bacterial pneumonia. Besides, subgroup analyses by the study design, severity of pneumonia, patient care setting, grouping method by SII and follow-up period further identified the association of SII with risk of mortality in pneumonia patients. Conclusions SII might serve as a prognostic indicator in pneumonia…
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