A Novel Potential Biomarker for Predicting the Development of Septic Embolism in Patients with Infective Endocarditis: Systemic Coagulation Inflammation Index

OBJECTIVE
Early diagnosis of septic emboli is crucial to prevent the associated morbidity and mortality. This study aimed to examine the relationship between the systemic coagulation ınflammation ındex (SCII) and septic embolism in patients with infective endocarditis (IE).


METHODS
We retrospectively analyzed the data of 167 IE patients treated at our tertiary care hospital between January 2007 and January 2023. We collected information on symptoms, comorbidities, predisposing valve diseases, prosthetic valves, devices, history of injectable drug use, blood culture results, echocardiographic findings, and complications. The SCII index was calculated using the formula: [platelet count (PLT) × fibrinogen level (g/L) / white blood cell count (WBC)].


RESULTS
The mean age of the patients was 61 years, with rheumatic valve disease being the most common predisposing factor. The most common etiologic microorganism was Staphylococcus species. Septic embolism developed in 25.7% of the patients, with the cerebral system being the most commonly affected (46.5%). The SCII was identified as an independent marker for the development of septic embolism. Receiver operating characteristic (ROC) curve analysis confirmed that an optimal SCII value of 59.8 predicted septic emboli with a sensitivity of 65.1% and a specificity of 59.6% (area under the ROC curve: 0.649 [95% confidence interval (CI): 0.556 - 0.743], P = 0.004).


CONCLUSION
This study demonstrates that high SCII levels are an independent predictor for the development of septic embolism in patients with IE.