Associations Between Systemic Immunity Inflammation Index, Aggregate Index of Systemic Inflammation, and Hospital Acquired Otitis Media in Children Aged ≤12 years with Bacterial Pneumonia

Liyuan Han,1,2 Yanhua Li,1,2 Chunyan Gao,1,2 Jie Liu,3 Jinghua Wu1,2 1Clinical Laboratory, Tangshan Maternal and Child Health Care Hospital, Tangshan, Hebei, People’s Republic of China; 2Key Laboratory of Molecular Medicine for Abnormal Development and Related Diseases, Tangshan Maternal and Child Health Care Hospital, Tangshan, Hebei, People’s Republic of China; 3Otorhinolaryngology Head and Neck Surgery, Tangshan Maternal and Child Health Care Hospital, Tangshan, Hebei, People’s Republic of ChinaCorrespondence: Jinghua Wu, Clinical Laboratory, Tangshan Maternal and Child Health Care Hospital, Tangshan, Hebei, People’s Republic of China, Email [email protected]: Hospital-acquired otitis media (OM) is a common complication in children with bacterial pneumonia, associated with prolonged morbidity. Systemic inflammation indices (SII and AISI) may serve as biomarkers for OM risk. This study aimed to evaluate the association of SII and AISI with hospital-acquired OM risk in children (≤ 12 years) with bacterial pneumonia.Patients and Methods: A total of 388 children (aged ≤ 12 years) diagnosed with bacterial pneumonia were enrolled in this study from January 2024 to June 2025.. Data included demographic characteristics, birth history, feeding history, and laboratory tests. Logistic regression analysis was used to analyze the relationship between SII, AISI, and the risk of OM. This study constructed a nomogram prediction model, and the performance of the model was assessed by the area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis (DCA).Results: The majority of patients were male (54.90%) and aged ≤ 3 years (55.93%). Based on OM status, children were divided into No-OM group (n = 289) and OM group (n = 99). The OM group showed significantly elevated levels of inflammatory markers (WBC, NEU, MON, PLT, CRP, SII and AISI), alongside lower levels of RBC, HGB, and TP, compared to the No-OM group (all p< 0.05). Multivariate analysis found log2-SII (OR = 1.38, 95% CI: 1.05– 1.82, p = 0.021) and log2-AISI (OR = 1.37, 95% CI: 1.07– 1.78, p < 0.001) were risk factors of hospital acquired OM. Compared to log2-SII model (0.827, 95% CI: 0.780– 0.875), log2-AISI model (0.834, 95% CI: 0.788– 0.881) demonstrated superior discriminatory ability. Both models exhibited a favorable clinical benefit rate. Additionally, restricted cubic spline (RCS) analysis showed a significant linear relationship between log2-SII, log2-AISI and OM risk (all P for nonlinear > 0.05), with inflection points at 9.71 (log2-SII) and 8.16 (log2-AISI).Conclusion: This study established the predictive value of SII and AISI for hospital acquired OM in children aged ≤ 12 years with bacterial pneumonia. Integrating them into clinical practice can guide targeted prevention and thereby improve prognosis.Keywords: systemic immunity inflammation index, aggregate index of systemic inflammation, bacterial pneumonia, otitis media, inflammation