Akademik Veri Yönetim Sistemi
EXPERIMENTAL AND THERAPEUTIC MEDICINE, cilt.30, sa.244, ss.1-10, 2025 (SCI-Expanded)
Abstract. Dilated cardiomyopathy (DCM) is a major cause of
heart failure and transplantation in children. Despite advances
in care, predicting outcomes remains difficult. Inflammatory
markers, such as the neutrophil‑to‑lymphocyte ratio (NLR) and
the systemic inflammatory index (SII), have demonstrated prog‑
nostic value in adults, but their role in pediatric DCM remains
unclear. The present study aimed to assess the association of
NLR, SII and other clinical, laboratory and echocardiographic
parameters with mortality in pediatric DCM. In the present
retrospective single‑center study, 52 pediatric patients with
DCM diagnosed between January 2000 and June 2021 were
analyzed. Demographic, clinical, laboratory and echocardio‑
graphic data at diagnosis were collected from hospital electronic
medical records. NLR and SII were calculated from complete
blood counts, whereas mortality was the primary outcome.
Statistical methods included receiver operating characteristic
(ROC) curve analysis, Kaplan‑Meier survival estimates and Cox
regression. In the present study, 16 patients (30.8%) succumbed
during follow‑up, and NLR and SII were found to be signifi‑
cantly higher in deceased patients compared with survivors
(P=0.003 and P=0.016, respectively). ROC analysis confirmed
the predictive value of NLR (AUC, 0.785) and SII (AUC, 0.728).
The optimal cut‑off values were >2.75 for NLR and >1,428,898
for SII. Cox regression identified parameters associated with
mortality, including low serum sodium and magnesium levels,
elevated NLR and SII, reduced mitral E wave velocity and
positive family history of DCM. In conclusion, elevated NLR
and SII at diagnosis are associated with increased mortality in
pediatric patients with DCM. As cost‑effective and easily acces‑
sible markers of systemic inflammation, these indices may serve
as useful adjuncts to conventional risk assessment, particularly
in settings with limited access to advanced laboratory testing.
However, further prospective multicenter studies are needed to
validate their prognostic role.