Prognostic Performance of the Pan-Immune-Inflammation Value in Critically Ill Patients with Crimean-Congo Hemorrhagic Fever

Serkan Şimşek; Oğuz Gündoğdu; Onur Avcı; Cemil İsbir; İclal Özdemir Kol; Kenan Kaygusuz; Sinan Gürsoy

doi:10.7197/cmj.1991752

EN TR

Prognostic Performance of the Pan-Immune-Inflammation Value in Critically Ill Patients with Crimean-Congo Hemorrhagic Fever

Abstract

Objective: The Pan-Immune-Inflammation Value (PIV) has recently emerged as a promising inflammation-based biomarker in several malignant and inflammatory diseases. However, its prognostic significance in Crimean-Congo hemorrhagic fever (CCHF) has not previously been investigated. This study evaluated the prognostic value of admission PIV in critically ill patients with CCHF and compared its performance with established disease-specific severity scores and other inflammatory biomarkers. Methods: This retrospective observational cohort study included 110 adult patients with laboratory-confirmed CCHF admitted to the intensive care unit of a tertiary referral hospital between 2014 and 2025. Admission PIV, Systemic Immune-Inflammation Index (SII), Systemic Inflammation Response Index (SIRI), fibrinogen-to-albumin ratio (FAR), and Severity Grading Score (SGS) were evaluated. Receiver operating characteristic (ROC) analysis, Spearman correlation, Kaplan–Meier survival analysis, and multivariable logistic regression were performed to assess their association with in-hospital mortality. Results: PIV showed poor discriminatory ability for predicting in-hospital mortality (AUC=0.508) and was not independently associated with mortality in multivariable analysis (OR=1.199, 95% CI 0.80–1.79; p=0.373). In contrast, SGS demonstrated the highest predictive performance (AUC=0.739) and remained the only independent predictor of mortality (OR=1.382, 95% CI 1.11–1.71; p=0.003). FAR showed high sensitivity (91.7%) but limited specificity (40.0%). PIV correlated significantly with APACHE II, SIRI, SII, blood urea nitrogen, creatinine, and SGS but not with SOFA. Conclusion: Admission PIV has limited prognostic utility in critically ill patients with CCHF and does not provide incremental prognostic value beyond established disease-specific severity scores. SGS remains the most reliable predictor of mortality in this patient population.

Keywords

Kritik Kırım-Kongo Kanamalı Ateşi Hastalarında Pan-İmmün-İnflamasyon Değerinin Prognostik Performansı

Abstract

Amaç: Pan-İmmün-İnflamasyon Değeri (PIV), son yıllarda çeşitli malign ve inflamatuvar hastalıklarda umut verici bir inflamasyon temelli biyobelirteç olarak tanımlanmıştır. Ancak, Kırım-Kongo Kanamalı Ateşi (KKKA) hastalarında prognostik değeri daha önce araştırılmamıştır. Bu çalışmada, yoğun bakım ünitesinde tedavi edilen kritik KKKA hastalarında başvuru anındaki PIV'nin prognostik değeri değerlendirilmiş ve performansı yerleşik hastalığa özgü şiddet skorları ile diğer inflamatuvar biyobelirteçlerle karşılaştırılmıştır. Yöntem: Bu retrospektif gözlemsel kohort çalışmasına, 2014–2025 yılları arasında üçüncü basamak bir merkezin yoğun bakım ünitesine yatırılan laboratuvar doğrulanmış KKKA tanılı 110 erişkin hasta dahil edildi. Başvuru sırasındaki PIV, Sistemik İmmün-İnflamasyon İndeksi (SII), Sistemik İnflamasyon Yanıt İndeksi (SIRI), fibrinojen/albümin oranı (FAR) ve Hastalık Şiddet Skoru (Severity Grading Score, SGS) değerlendirildi. Hastane içi mortalite ile ilişkilerini belirlemek amacıyla ROC eğrisi analizi, Spearman korelasyon analizi, Kaplan–Meier sağkalım analizi ve çok değişkenli lojistik regresyon analizi yapıldı. Bulgular: PIV'nin hastane içi mortaliteyi öngörmedeki ayırt edici gücü düşüktü (AUC=0,508) ve çok değişkenli analizde mortalite ile bağımsız olarak ilişkili bulunmadı (OR=1,199; %95 GA: 0,80–1,79; p=0,373). Buna karşılık SGS, en yüksek öngörü performansını gösterdi (AUC=0,739) ve mortalitenin tek bağımsız belirleyicisi olarak saptandı (OR=1,382; %95 GA: 1,11–1,71; p=0,003). FAR yüksek duyarlılık (%91,7) ancak düşük özgüllük (%40,0) gösterdi. PIV; APACHE II, SIRI, SII, kan üre azotu, kreatinin ve SGS ile anlamlı korelasyon gösterirken, SOFA skoru ile anlamlı ilişki saptanmadı. Sonuç: Yoğun bakım ünitesinde tedavi edilen kritik KKKA hastalarında başvuru anındaki PIV'nin prognostik değeri sınırlıdır ve yerleşik hastalığa özgü şiddet skorlarına ek prognostik katkı sağlamamaktadır. Bu hasta grubunda mortalitenin öngörülmesinde SGS en güvenilir prognostik belirteç olmaya devam etmektedir.

Keywords

References

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Details

Primary Language

English

Subjects

Health and Community Services

Journal Section

Research Article

Authors

Serkan Şimşek
0009-0007-7889-8147
Türkiye

Oğuz Gündoğdu ^*
0000-0002-8864-0015
Türkiye

Onur Avcı
0000-0003-0743-754X
Türkiye

Cemil İsbir
0000-0003-4094-7584
Türkiye

İclal Özdemir Kol
0000-0001-8247-440X
Türkiye

Kenan Kaygusuz
0000-0002-0745-4633
Türkiye

Sinan Gürsoy
0000-0003-0259-9750
Türkiye

Publication Date

September 30, 2026

Submission Date

July 10, 2026

Acceptance Date

September 22, 2026

Published in Issue

Year 2026 Volume: 48 Number: 3

DOI

https://doi.org/10.7197/cmj.1991752

IZ

https://izlik.org/JA68WC66NB

Cite

RIS / Bibtex

APA

Şimşek, S., Gündoğdu, O., Avcı, O., İsbir, C., Özdemir Kol, İ., Kaygusuz, K., & Gürsoy, S. (2026). Prognostic Performance of the Pan-Immune-Inflammation Value in Critically Ill Patients with Crimean-Congo Hemorrhagic Fever. Cumhuriyet Medical Journal, 48(3), 135-141. https://doi.org/10.7197/cmj.1991752

AMA

1.Şimşek S, Gündoğdu O, Avcı O, et al. Prognostic Performance of the Pan-Immune-Inflammation Value in Critically Ill Patients with Crimean-Congo Hemorrhagic Fever. CMJ. 2026;48(3):135-141. doi:10.7197/cmj.1991752

Chicago

Şimşek, Serkan, Oğuz Gündoğdu, Onur Avcı, et al. 2026. “Prognostic Performance of the Pan-Immune-Inflammation Value in Critically Ill Patients With Crimean-Congo Hemorrhagic Fever”. Cumhuriyet Medical Journal 48 (3): 135-41. https://doi.org/10.7197/cmj.1991752.

EndNote

Şimşek S, Gündoğdu O, Avcı O, İsbir C, Özdemir Kol İ, Kaygusuz K, Gürsoy S (September 1, 2026) Prognostic Performance of the Pan-Immune-Inflammation Value in Critically Ill Patients with Crimean-Congo Hemorrhagic Fever. Cumhuriyet Medical Journal 48 3 135–141.

IEEE

[1]S. Şimşek et al., “Prognostic Performance of the Pan-Immune-Inflammation Value in Critically Ill Patients with Crimean-Congo Hemorrhagic Fever”, CMJ, vol. 48, no. 3, pp. 135–141, Sept. 2026, doi: 10.7197/cmj.1991752.

ISNAD

Şimşek, Serkan - Gündoğdu, Oğuz - Avcı, Onur - İsbir, Cemil - Özdemir Kol, İclal - Kaygusuz, Kenan - Gürsoy, Sinan. “Prognostic Performance of the Pan-Immune-Inflammation Value in Critically Ill Patients With Crimean-Congo Hemorrhagic Fever”. Cumhuriyet Medical Journal 48/3 (September 1, 2026): 135-141. https://doi.org/10.7197/cmj.1991752.

JAMA

1.Şimşek S, Gündoğdu O, Avcı O, İsbir C, Özdemir Kol İ, Kaygusuz K, Gürsoy S. Prognostic Performance of the Pan-Immune-Inflammation Value in Critically Ill Patients with Crimean-Congo Hemorrhagic Fever. CMJ. 2026;48:135–141.

MLA

Şimşek, Serkan, et al. “Prognostic Performance of the Pan-Immune-Inflammation Value in Critically Ill Patients With Crimean-Congo Hemorrhagic Fever”. Cumhuriyet Medical Journal, vol. 48, no. 3, Sept. 2026, pp. 135-41, doi:10.7197/cmj.1991752.

Vancouver

1.Serkan Şimşek, Oğuz Gündoğdu, Onur Avcı, Cemil İsbir, İclal Özdemir Kol, Kenan Kaygusuz, Sinan Gürsoy. Prognostic Performance of the Pan-Immune-Inflammation Value in Critically Ill Patients with Crimean-Congo Hemorrhagic Fever. CMJ. 2026 Sep. 1;48(3):135-41. doi:10.7197/cmj.1991752