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系统性免疫炎症指数预测动脉瘤性蛛网膜下腔出血的预后。

Systemic immune-inflammation index predicts the outcome after aneurysmal subarachnoid hemorrhage.

机构信息

Department of Neurosurgery, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.

Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China.

出版信息

Neurosurg Rev. 2022 Apr;45(2):1607-1615. doi: 10.1007/s10143-021-01681-4. Epub 2021 Oct 31.

Abstract

Systemic inflammatory response is closely related to the pathogenesis and prognosis in critical patients. Recently, systemic immune-inflammation index (SII), an indicator of systemic inflammatory response, was proved to predict the outcome in cancerous and non-cancerous diseases. The aim of this study is to investigate the association between SII on admission and 6-month outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH). The clinical data and prognosis of 76 patients with aSAH were analyzed. The 6-month outcome was assessed by the modified Rankin scale(mRS). The unfavorable outcome was defined as mRS score ≥ 3. In addition, multivariate analysis was conducted to investigate factors independently associated with the favorable outcome. Receiver operating characteristic (ROC) curve analysis was undertaken to identify the best cut-off value of SII for the discriminate between favorable and unfavorable outcome in these patients. Thirty-six patients (47.4%) in our study had an unfavorable outcome (mRS ≥ 3) at 6 months, and twenty-four (66.7%) of them were in the high-SII group. A significantly higher SII on admission was observed in patients with unfavorable functional outcome at 6 months. Binary logistic regression analysis showed that there was an independent association between SII on admission and 6-month clinical outcome (adjusted OR = 4.499, 95%CI: 1.242-16.295, P < 0.05). The AUC of the SII for predicting unfavorable outcome was 0.692 (95% CI: 0.571-0.814, P < 0.05). Systemic immune-inflammation index (SII) could be a novel independent prognostic factor for aSAH patients at the early stage of the disease.

摘要

全身炎症反应与危重症患者的发病机制和预后密切相关。最近,全身免疫炎症指数(SII)作为全身炎症反应的指标,已被证明可预测癌症和非癌症疾病的预后。本研究旨在探讨入院时 SII 与颅内动脉瘤性蛛网膜下腔出血(aSAH)患者 6 个月结局的关系。分析了 76 例 aSAH 患者的临床资料和预后。采用改良 Rankin 量表(mRS)评估 6 个月结局。预后不良定义为 mRS 评分≥3。此外,还进行了多变量分析,以探讨与良好结局独立相关的因素。进行了受试者工作特征(ROC)曲线分析,以确定 SII 对这些患者良好和不良结局的最佳截断值。本研究 36 例(47.4%)患者 6 个月时预后不良(mRS≥3),其中 24 例(66.7%)患者 SII 较高。入院时 SII 较高的患者 6 个月时功能结局不良。二元逻辑回归分析显示,入院时 SII 与 6 个月临床结局独立相关(调整 OR=4.499,95%CI:1.242-16.295,P<0.05)。SII 预测不良结局的 AUC 为 0.692(95%CI:0.571-0.814,P<0.05)。SII 可能是 aSAH 患者疾病早期的一个新的独立预后因素。

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