Department of Neurosurgery, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, China.
Department of Neurosurgery, Clinical Medical College of Yangzhou University, Yangzhou, China.
Br J Neurosurg. 2023 Dec;37(6):1560-1566. doi: 10.1080/02688697.2020.1831438. Epub 2020 Oct 12.
To investigate the prognostic value of inflammatory markers, including neutrophil/lymphocyte ratio (NLR), derived neutrophil/lymphocyte ratio (dNLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), prognostic nutritional index (PNI), and systemic inflammation response index (SIRI) in patients with aneurismal subarachnoid hemorrhage (aSAH), and then develop a Nomogram prognostic model.
We analysed 178 aSAH patients who underwent surgery at Subei People's Hospital of Jiangsu province from January 2015 to December 2017. Patients were divided into two groups according to Glasgow outcome scale (GOS) score at 3 months. Univariate and multivariate analysis were used to identify the association between inflammatory markers and prognosis. Subsequently, we identified the best cutoff of SIRI for unfavorable outcome using receiver operating characteristic (ROC) curve analysis and compared the clinical data between high and low SIRI levels. We further evaluated the additive value of SIRI by comparing prognostic nomogram models with and without it.
A total of 47 (26.4%) patients had a poor outcome. Multivariate logistic regression analysis showed that SIRI was an independent risk factor of poor outcome. The SIRI of 4.105 × 10/L was identified as the optimal cutoff value, patients with high SIRI levels had worse clinical status and higher rates of unfavorable outcome. ROC analysis showed that a nomogram model combining the SIRI and other conventional factors showed more favorable predictive ability than the model without the SIRI.
SIRI was independently correlated with unfavorable outcome in SAH patients, and the nomogram model combining the SIRI had more favorable discrimination ability.
探讨炎症标志物（包括中性粒细胞/淋巴细胞比值（NLR）、衍生中性粒细胞/淋巴细胞比值（dNLR）、血小板/淋巴细胞比值（PLR）、单核细胞/淋巴细胞比值（MLR）、预后营养指数（PNI）和全身炎症反应指数（SIRI））对动脉瘤性蛛网膜下腔出血（aSAH）患者的预后价值，并建立列线图预后模型。
我们分析了 2015 年 1 月至 2017 年 12 月在江苏省苏北人民医院接受手术治疗的 178 例 aSAH 患者。根据 3 个月时格拉斯哥结局量表（GOS）评分，将患者分为两组。采用单因素和多因素分析确定炎症标志物与预后的关系。随后，我们通过接受者操作特征（ROC）曲线分析确定 SIRI 预测不良结局的最佳截断值，并比较高低 SIRI 水平之间的临床数据。我们通过比较有无 SIRI 的预后列线图模型，进一步评估 SIRI 的附加价值。
共有 47 例（26.4%）患者预后不良。多因素 logistic 回归分析表明，SIRI 是不良预后的独立危险因素。SIRI 为 4.105×10/L 时，为最佳截断值，SIRI 水平较高的患者临床状态较差，不良结局发生率较高。ROC 分析表明，结合 SIRI 和其他常规因素的列线图模型比不包含 SIRI 的模型具有更好的预测能力。
SIRI 与 aSAH 患者的不良预后独立相关，结合 SIRI 的列线图模型具有更好的判别能力。
