Prognostic Significance of the Systemic Immune-Inflammation Index in Patients Presenting to the Emergency Department with Mushroom Intoxication

Objective This study aimed to investigate the prognostic value of systemic immune-inflammation indices, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and modified inflammation indices (MII-1, MII-2, MII-3), in patients presenting to the emergency department (ED) with mushroom intoxication. Materials and Methods This retrospective observational study included adult patients diagnosed with mushroom poisoning at a tertiary ED between June 2018 and December 2024. Demographic, clinical, and laboratory data were collected, and systemic inflammation-based indices were calculated. Patients were categorized according to clinical outcomes: discharge, ward admission, or intensive care unit (ICU) admission. Kruskal-Wallis and ROC analyses were performed to evaluate the predictive value of these indices for hospitalization. Results A total of 45 patients were included (median age: 55 years; 48.9% female). No significant differences were found among NLR, PLR, MLR, SII, SIRI, or MII subtypes across the outcome groups (p > 0.05 for all). ROC analysis showed poor discriminatory power for hospitalization, with the highest area under the curve (AUC) values observed for SII (0.619) and MII-3 (0.639), without statistical significance. Conclusion Systemic inflammation indices, including SII and other derived ratios, did not demonstrate sufficient predictive value for hospitalization or disease severity in mushroom intoxication. While these biomarkers may have prognostic utility in other toxicological conditions, their role in mild-to-moderate mushroom poisoning appears limited. Further prospective studies with larger cohorts and toxin-specific stratification are warranted.