Department of Neurosurgery, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China.
Neurosurg Rev. 2022 Apr;45(2):1607-1615. doi: 10.1007/s10143-021-01681-4. Epub 2021 Oct 31.
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.
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。