JHSM
Journal of Health Sciences and Medicine

Journal of Health Sciences and Medicine (JHSM) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

ISSN: Active
eISSN: 2636-8579
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Submit Manuscript

Index
Original Article
Prognostic importance of the pan-immune-inflammation value and potential serological biomarkers of complicated peritonsillar abscesses
Abstract
Aims: A peritonsillar abscess (PTA) is the most common deep infection of the head and neck and can sometimes be associated with life-threatening complications. Clinical symptoms in patients with a complicated peritonsillar abscess (CPTA) may not always reflect the severity of this disease. Therefore, monitoring these patients with inexpensive and easily accessible hematological parameters is essential. Recently, certain inflammatory monitoring markers have gained acceptance. In this study, we aimed to determine the role of the pan-immune-inflammation value (PIV) in patients with a PTA at a high risk of complications.
Methods: Patients aged 18 years and older who were diagnosed with a PTA and hospitalized in our clinic between October 10, 2022, and October 1, 2024 were retrospectively analyzed. The patients were divided into the CPTA group and the uncomplicated peritonsillar abscess (UPTA) group. Demographic characteristics, laboratory findings, and complications observed in the emergency department were evaluated.
Results: A total of 104 patients were included in the study, with 71 in the UPTA group and 33 in the CPTA group. PIV values were significantly higher in the CPTA group compared to the UPTA group. The diagnostic value of PIV in predicting PTA-related complications was assessed using receiver operating characteristic curve analysis. A PIV cutoff value of 989.6 (AUC: 0.838; 95% confidence interval: 0.753-0.903) demonstrated a sensitivity of 72.7% and a specificity of 85.9%, indicating superior predictive power for PTA-related complications compared to NLR, MLR, and SII.
Conclusion: Our findings suggest that the PIV is a rapid, simple, and reliable marker for predicting the severity of PTAs and potential complications.

Keywords : Complication, emergency department, pan-immune-inflammation value, peritonsillar abscess

Download Article


1. Steyer TE. Peritonsillar abscess: diagnosis and treatment. Am Fam Physician. 2002;65(1):93-96.
2. Şentürk M, Azgın İ, Övet G, Alataş N, Ağırgöl B, Yılmaz E. The role of the mean platelet volume and neutrophil-to-lymphocyte ratio in peritonsillar abscesses. Braz J Otorhinolaryngol. 2016;82(6):662-667. doi:10.1016/j.bjorl.2015.11.018
3. Sousa Menezes A, Ribeiro DC, Guimarães JR, Lima AF, Dias L. Management of pediatric peritonsillar and deep neck infections- cross- sectional retrospective analysis. World J Otorhinolaryngol Head Neck Surg. 2019;5(4):207-214. doi:10.1016/j.wjorl.2019.04.003
4. Lepelletier D, Pinaud V, Le Conte P, et al. Peritonsillar abscess (PTA): clinical characteristics, microbiology, drug exposures and outcomes of a large multicenter cohort survey of 412 patients hospitalized in 13 French university hospitals. Eur J Clin Microbiol Infect Dis. 2016;35(5):867-873. doi:10.1007/s10096-016-2609-9
5. Klug TE, Greve T, Hentze M. Complications of peritonsillar abscess. Ann Clin Microbiol Antimicrob. 2020;19(1):32. doi:10.1186/s12941-020-00375-x
6. Maroldi R, Farina D, Ravanelli M, Lombardi D, Nicolai P. Emergency imaging assessment of deep neck space infections. Semin Ultrasound CT MR. 2012;33(5):432-442. doi:10.1053/j.sult.2012.06.008
7. Treviño-Gonzalez JL, Acuña-Valdez F, Santos-Santillana KM. Prognostic value of Systemic Immune-Inflammation Index and serological biomarkers for deep neck infections. Med Oral Patol Oral Cir Bucal. 2024;29(1):128-134. doi:10.4317/medoral.26130
8. Wang RH, Wen WX, Jiang ZP, et al. The clinical value of neutrophil-to-lymphocyte ratio (NLR), Systemic Immune-Inflammation Index (SII), platelet-to-lymphocyte ratio (PLR) and Systemic Inflammation Response Index (SIRI) for predicting the occurrence and severity of pneumonia in patients with intracerebral hemorrhage. Front Immunol. 2023;14:1115031. doi:10.3389/fimmu.2023.1115031
9. Karaduman A, Yılmaz C, Keten MF, et al. Prognostic value of pan immune-inflammation value in patients undergoing unprotected left main coronary artery stenting. Biomark Med. 2024;21:1-11. doi:10.1080/ 17520363.2024.2412515
10. Turan YB. The prognostic importance of the pan-immune-inflammation value in patients with septic shock. BMC Infect Dis. 2024;24(1):69. doi:10. 1186/s12879-023-08963-w
11. Baba Y, Nakagawa S, Toihata T, et al. Pan-immune-inflammation value and prognosis in patients with esophageal cancer. Ann Surg Open. 2021; 3(1):113. doi:10.1097/AS9.0000000000000113
12. Yang XC, Liu H, Liu DC, Tong C, Liang XW, Chen RH. Prognostic value of pan-immune-inflammation value in colorectal cancer patients: a systematic review and meta-analysis. Front Oncol. 2022;12:1036890. doi:10.3389/fonc.2022.1036890
13. Tutan D, Doğan AG. Pan-Immune-Inflammation Index as a Biomarker for rheumatoid arthritis progression and diagnosis. Cureus. 2023;15(10): 46609. doi:10.7759/cureus.46609
14. Qi X, Qiao B, Song T, et al. Clinical utility of the pan-immune-inflammation value in breast cancer patients. Front Oncol. 2023;13: 1223786. doi:10.3389/fonc.2023.1223786
15. Liao QQ, Mo YJ, Zhu KW, et al. Platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and eosinophil-to-lymphocyte ratio (ELR) as biomarkers in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Int J Chron Obstruct Pulmon Dis. 2024;19:501-18. doi:10.2147/COPD.S447519
16. Aksoy A, Demirkıran BB, Bora A, Doğan M, Altuntaş EE. Comprehensive evaluation of deep neck infections: a retrospective analysis of 111 cases. Laryngoscope Investig Otolaryngol. 2024;9(5):e70027. doi:10.1002/lio2. 70027
17. Subbotina MV, Prikhodko TD, Barakin AO, Butyrin OM, Puzrenkova YD, Bakhaeva OS. Ul’trazvukovaya diagnostika paratonzillyarnogo abstsessa: preimushchestva i nedostatki. Vestn Otorinolaringol. 2024; 89(4):81-85.
18. Kadrie A, Ward C, Chanamolu M, Berry J, Gillespie MB. Peritonsillar abscess outcomes with and without computed tomography: a retrospective cohort study. Laryngoscope. 2024;134(12):4911-4917. doi: 10.1002/lary.31629
19. Maroldi R, Farina D, Ravanelli M, Lombardi D, Nicolai P. Emergency imaging assessment of deep neck space infections. Semin Ultrasound CT MR. 2012;33(5):432-442. doi:10.1053/j.sult.2012.06.008
20. Kohen B, Perez M, Mckay J, Zamora R, Xu C. The use of point of care ultrasound in diagnosis of peritonsillar abscess. POCUS J. 2023;8(2):116-117. doi:10.24908/pocus.v8i2.16568
21. Esposito S, De Guido C, Pappalardo M, et al. Retropharyngeal, parapharyngeal and peritonsillar abscesses. Children (Basel). 2022;9(5): 618. doi:10.3390/children9050618
22. Unal O, Kumbul YC, Akin V. Importance of biomarkers in streptococcal acute tonsillitis & peritonsillar abscess. Indian J Med Res. 2024;159(6): 637-643. doi:10.25259/ijmr_940_23
23. Loonen AJ, de Jager CP, Tosserams J, et al. Biomarkers and molecular analysis to improve bloodstream infection diagnostics in an emergency care unit. PLoS One. 2014;9(1):e87315. doi:10.1371/journal.pone.0087315
24. de Jager CP, van Wijk PT, Mathoera RB, de Jongh-Leuvenink J, van der Poll T, Wever PC. Lymphocytopenia and neutrophil-lymphocyte count ratio predict bacteremia better than conventional infection markers in an emergency care unit. Crit Care. 2010;14(5):R192. doi:10.1186/cc9309
25. Baglam T, Binnetoglu A, Yumusakhuylu AC, Gerin F, Demir B, Sari M. Predictive value of the neutrophil-to-lymphocyte ratio in patients with deep neck space infection secondary to acute bacterial tonsillitis. Int J Pediatr Otorhinolaryngol. 2015;79:1421-1424. doi:10.1016/j.ijporl.2015. 06.016
26. Menekşe TS, Kaçer İ, Hacımustafaoğlu M, Gül M, Ateş C. C-reactive protein to albumin ratio may predict in-hospital mortality in non-ST elevation myocardial infarction. Biomark Med. 2024;18(3):103-113. doi: 10.2217/bmm-2023-0682
27. Kaçer EÖ. Erratum to the prognostic value of Systemic Immune Inflammation Index in children with carbon monoxide poisoning. J Contemp Med. 2024;14(4):222. doi:10.16899/jcm.1347034
28. Zhang F, Li L, Wu X, et al. Pan-immune-inflammation value is associated with poor prognosis in patients undergoing peritoneal dialysis. Ren Fail. 2023;45(1):2158103. doi:10.1080/0886022X.2022.2158103
29. Zhou H, Zhang S, Miao D, Cao R. U-shaped association between pan-immune-inflammation value and periodontitis: NHANES 2009-2014. J Periodontol. 2024. doi:10.1002/JPER.24-0318
30. Murat B, Murat S, Ozgeyik M, Bilgin M. Comparison of pan-immune-inflammation value with other inflammation markers of long-term survival after ST-segment elevation myocardial infarction. Eur J Clin Invest. 2023;53(1):13872. doi:10.1111/eci.13872
Article available in :
Volume 8, Issue 2, 2025
Page : 269-274
https://doi.org/10.32322/jhsm.1610426
Article Information
Received : 31 Ara 2024
Accepted : 07 Şub 2025
Published : 21 Mar 2025
Corresponding Author :

Tuğba Sanalp Menekşe: Department of Emergency Medicine, Ankara Etlik City Hospital, Ankara, Turkiye

[email protected]
Citation : Sanalp Menekşe T, Şirin İ, Güçlü Utlu S, Sert ET. Prognostic importance of the pan-immune-inflammation value and potential serological biomarkers of complicated peritonsillar abscesses. J Health Sci Med. 2025;8(2):269-274.

Read: 20
Cited: 0
Download : 19
_Footer