The Relationship Between the Systemic Inflammatory-Immunity Index and Acute Postoperative Pain Severity Following Traumatic Hip Fracture Surgery in Elderly Patients with Rheumatoid Arthritis

Qasem Beglou, Arezo; Maroufi, Parham

The Relationship Between the Systemic Inflammatory-Immunity Index and Acute Postoperative Pain Severity Following Traumatic Hip Fracture Surgery in Elderly Patients with Rheumatoid Arthritis

Document Type : Original Article

Authors

Arezo Qasem Beglou ¹

Parham Maroufi ²

¹ Assistant Professor, Department of Rheumatology, Faculty of Medicine, Tabriz University of Medical Sciences, Imam Reza Hospital

² Associate Professor, Department of Orthopaedic Surgery, Faculty of Medicine, Tabriz University of Medical Sciences, Imam Reza Hospital

Abstract

Background and Objective: Traumatic hip fractures in elderly patients with rheumatoid arthritis are associated with significant postoperative pain that adversely impacts recovery and overall quality of life. Identification of reliable biomarkers, such as the systemic inflammatory-immunity index, may enhance the prediction of pain severity and refine pain management strategies. This study aims to investigate the role of the systemic inflammatory-immunity index in predicting postoperative pain outcomes, ultimately improving care for this vulnerable population through personalized, evidence-based approaches.
Materials & Methods: This descriptive cross-sectional study was conducted in the winter of 2024 at Shahid and Imam Reza Hospitals, affiliated with Tabriz University of Medical Sciences. A total of 112 elderly patients with rheumatoid arthritis were recruited via convenience sampling. Demographic characteristics, clinical factors, and biomarkers (neutrophil, lymphocyte, and platelet counts) were collected to compute the systemic inflammatory-immunity index. Postoperative pain severity, opioid consumption, and hemodynamic parameters were assessed for their correlation with the systemic inflammatory-immunity index using Pearson correlation coefficients.
Results: Correlation analyses demonstrated a significant positive relationship between the systemic inflammatory-immunity index during hospitalization and acute postoperative pain severity, as measured by the pain intensity scale, within the first four hours post-surgery. The strongest correlation with the Visual Analog Scale (VAS) score was recorded at the second postoperative hour (R=0.658, P=0.009). Additionally, significant correlations were found at the first hour (R=0.596, P=0.014), third hour (R=0.488, P=0.026), and fourth hour (R=0.452, P=0.036); however, these correlations progressively diminished and were non-significant in subsequent hours.
Conclusion: The systemic inflammatory-immunity index is a valuable predictor of postoperative pain severity, hemodynamic instability, and extended hospital stays among elderly patients with rheumatoid arthritis.

Keywords

Systemic inflammatory-immunity index

postoperative pain

hemodynamic instability

length of hospital stay

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