Hakan GÜVEN, Demir ÇETİNTAŞ
Cardiovascular Surgery and Interventions - 2026;13(1):13-19
Objectives: The inflammatory prognostic index (IPI), a composite biomarker incorporating C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), and serum albumin (ALB), has recently emerged as a marker of systemic inflammation. This study aimed to investigate the predictive capacity of IPI for early adverse outcomes following carotid artery surgery. A retrospective cohort study was conducted in a single tertiary center. Patients and methods: Medical records of 286 patients who underwent carotid artery surgery between January 2021 and December 2024 were retrospectively reviewed. Patients were stratified into two groups according to early postoperative outcomes: those with adverse events (major cerebrovascular accident, myocardial infarction, or 30-day mortality) and those without. Preoperative CRP, NLR, and ALB levels were collected to calculate the IPI using the formula (CRPxNLR)/ALB. Comparative analyses were performed between groups. Multivariate logistic regression identified independent predictors of adverse outcomes, and receiver operating characteristic (ROC) analysis was used to determine the optimal IPI cut-off point. Results: Adverse outcomes were observed in 20 patients (7%). The adverse group showed significantly higher IPI and CRP values, along with lower serum ALB levels, compared to the favorable group. In multivariate analysis, IPI emerged as the only independent predictor of adverse outcomes. ROC analysis identified an IPI threshold of 0.27, which predicted adverse outcomes with high sensitivity but moderate specificity. Conclusion: This study is the first to demonstrate that IPI is an independent predictor of early adverse outcomes following carotid artery surgery. Given its simplicity and cost-effectiveness, IPI may serve as a practical biomarker for preoperative risk stratification and clinical decision-making in vascular surgery
