Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea; Department of Neurosurgery, St. Vincent's Hospital, The Catholic University of Korea, Suwon, South Korea.
Department of Neurosurgery, St. Vincent's Hospital, The Catholic University of Korea, Suwon, South Korea.
World Neurosurg. 2021 Sep;153:e282-e289. doi: 10.1016/j.wneu.2021.06.113. Epub 2021 Jul 2.
Inflammation plays a pivotal role in acute ischemic stroke, and various inflammatory markers are known to predict prognosis of acute ischemic stroke. This study aimed to evaluate the prognostic value of systemic inflammation response index (SIRI) and systemic immune-inflammation index (SII) after mechanical thrombectomy (MT) for acute ischemic stroke caused by large artery occlusion.
The study enrolled 440 patients who underwent MT for large artery occlusion. SIRI and SII were calculated using laboratory data on admission. Prognosis was estimated with modified Rankin Scale at 3 months, and favorable clinical outcome was defined by a modified Rankin Scale score of 0-2. Receiver operating characteristic analysis was used to calculate the optimal cutoff values of SIRI and SII for predicting clinical outcome. Multivariate analysis was used to assess the relationship of SIRI and SII with clinical outcome.
In receiver operating characteristic analysis, the optimal cutoff values for SIRI and SII were 2.9 and 853, respectively (area under the curve 0.799, 95% confidence interval [CI] 0.756-0.843, P < 0.001 and area under the curve 0.679, 95% CI 0.643-0.745, P < 0.001, respectively). Multivariate analysis revealed that SIRI <2.9 (odds ratio 2.27, 95% CI 1.29-5.17, P = 0.019) and SII <853 (OR 1.82, 95% CI 1.16-3.10, P = 0.031) were independent predictors of favorable clinical outcome after MT.
Decreased SIRI and SII were associated with favorable clinical outcome after MT. SIRI and SII represent potential prognostic factors in patients undergoing MT for large artery occlusion.
炎症在急性缺血性卒中中起着关键作用,已知各种炎症标志物可预测急性缺血性卒中的预后。本研究旨在评估机械血栓切除术(MT)治疗大动脉闭塞性急性缺血性卒中后系统性炎症反应指数(SIRI)和系统性免疫炎症指数(SII)的预后价值。
本研究纳入了 440 例接受 MT 治疗的大动脉闭塞患者。入院时根据实验室数据计算 SIRI 和 SII。采用改良 Rankin 量表(mRS)在 3 个月时评估预后,良好的临床转归定义为 mRS 评分 0-2。采用受试者工作特征(ROC)曲线分析计算 SIRI 和 SII 预测临床转归的最佳截断值。采用多变量分析评估 SIRI 和 SII 与临床转归的关系。
在 ROC 分析中,SIRI 和 SII 的最佳截断值分别为 2.9 和 853,曲线下面积(AUC)分别为 0.799(95%置信区间 [CI]:0.756-0.843,P < 0.001)和 0.679(95%CI:0.643-0.745,P < 0.001)。多变量分析显示,SIRI <2.9(优势比 [OR]:2.27,95%CI:1.29-5.17,P = 0.019)和 SII <853(OR:1.82,95%CI:1.16-3.10,P = 0.031)是 MT 后良好临床转归的独立预测因素。
SIRI 和 SII 降低与 MT 后良好的临床转归相关。SIRI 和 SII 是接受 MT 治疗的大动脉闭塞患者潜在的预后因素。