Iranian Journal of Neonatology

Iranian Journal of Neonatology

Predictive Role of the Systemic Immune-Inflammation Index in Catheter-Related Thrombosis among Neonates: A Retrospective Study

Document Type : Original Article

Authors
Tugba Barsan Kaya 1
Zeynep Canan Ozdemir 2
Ozge Aydemir 1
Hulya Ozen 3
Simay Armagan 4
Ozge Surmeli Onay 1
Ener Cagrı Dinleyici 4
Ayse Neslihan Tekin 1
1 Division of Neonatology, Department of Pediatrics, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkiye
2 Division of Pediatric Hematology and Oncology, Department of Pediatrics, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkiye
3 Department of Biostatistics, Faculty of Medicine, Gulhane Faculty of Medicine, University of Health Sciences, Ankara, Turkıye
4 Department of Pediatrics, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkiye
10.22038/ijn.2025.84800.2628
Abstract
Background: This study aimed to evaluate changes in hematological parameters and the systemic immune-inflammation index (SII) to determine their utility in predicting and monitoring catheter-related thrombosis (CRT) in neonatal intensive care unit (NICU). We expect that this study will provide novel insights into the potential role of inflammation-based indices in the management of neonatal thrombosis.
Methods: A retrospective case-control study was conducted in a tertiary NICU over five years. Infants were divided into three groups: those with CRT, those with central venous catheters but without thrombosis (non-CRT), and healthy controls. Serial complete blood counts (CBCs) were analyzed, including inflammatory indices such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and SII.
Results: Compared to the other groups, CRT infants had significantly lower baseline hemoglobin levels and higher levels of white blood cells (WBC), absolute neutrophil count (ANC), NLR, C-reactive protein (CRP), and SII over time (p < 0.05 for all). No significant changes were found in monocyte count, MLR, or mean platelet volume. While SII decreased over time in the control group, it showed a rising trend in CRT infants, indicating ongoing inflammation.
Conclusion: Serial measurements of WBC, ANC, NLR, and SII may serve as useful indicators of thrombotic risk in catheterized neonates. These indices may provide better predictive value than standard CBC parameters. Larger multicenter studies are warranted to validate these findings. Larger multicenter studies are needed to confirm these findings.
Keywords
Inflammation
Neonatal intensive care
Systemic immune-inflammation index (SII)
Thrombosis
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Iranian Journal of Neonatology
Volume 16, Issue 3
Summer 2025
Pages 31-41