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BMC Pulm Med . The systemic immune-inflammation index combined with the platelet-to-lymphocyte ratio demonstrates notable potential as a prognostic

tetano

Editor, Senior Moderator
BMC Pulm Med


. 2026 May 1.
doi: 10.1186/s12890-026-04300-4. Online ahead of print.
The systemic immune-inflammation index combined with the platelet-to-lymphocyte ratio demonstrates notable potential as a prognostic tool for older adults with pneumonia caused by influenza A virus infection: a retrospective cohort study

PiaoPiao Wu[SUP] 1 [/SUP], Jiadun Wang[SUP] 1 [/SUP], Jingping Cheng[SUP] 2 [/SUP]


Affiliations
Abstract

Background: The clinical course of influenza A virus (IAV) pneumonia in elderly patients is highly variable and strongly influenced by immunosenescence and dysregulated inflammation. Despite the prognostic relevance of inflammatory markers, reliably stratifying high-risk patients remains challenging. We investigated the combined potential of the systemic immune-inflammation index (SII) and the platelet-to-lymphocyte ratio (PLR) as a novel, accessible composite prognostic tool for this susceptible population.
Methods: A retrospective analysis was conducted on 160 patients aged ≥ 65 years with IAVP, who were divided into favorable prognosis (CURB-65 < 3, n = 71) and poor prognosis (CURB-65 ≥ 3, n = 89) groups based on their CURB-65 scores.
Results: The poor prognosis group exhibited significantly higher levels of white blood cells, neutrophils, C-reactive protein (CRP), interleukin-6 (IL-6), erythrocyte sedimentation rate (ESR), blood urea nitrogen (BUN), creatinine (Cr), PLR, and SII, as well as lower levels of prealbumin, albumin, total protein, and lymphocyte counts (all P < 0.05).
Conclusion: Both PLR and SII are positively correlated with disease severity and serve as independent prognostic indicators in elderly IAVP patients. Their combination enhances the accuracy and generalizability of clinical risk stratification models.

Keywords: Elderly patients; Influenza A virus; Platelet to Lymphocyte Ratio; Pneumonia; Systemic Immune-Inflammation Index.

 
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