全身免疫炎症指数可预测行开颅术的自发性脑出血患者的急性肾损伤和预后：一项单中心回顾性研究。
Systemic immune-inflammation index may predict the acute kidney injury and prognosis in patients with spontaneous cerebral hemorrhage undergoing craniotomy: a single-center retrospective study.
机构信息
Department of Nephrology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China.
Department of Neurosurgery, the Affiliated Hospital of Qingdao University, Qingdao, 266003, China.
出版信息
BMC Nephrol. 2023 Mar 25;24(1):73. doi: 10.1186/s12882-023-03124-2.
BACKGROUND
The systemic immune-inflammation index (SII) is an emerging prognostic marker of cancer. We aimed to explore the predictive ability of the SII on acute kidney injury (AKI) and prognosis in patients with spontaneous cerebral hemorrhage (SCH) who underwent craniotomy.
METHODS
Patients with SCH who underwent craniotomy between 2014 and 2021 were enrolled in this study. The epidemiology and predictive factors for AKI after SCH were analyzed. The prognostic factors for clinical outcomes in patients with SCH and AKI were further investigated. The prognostic factors were then analyzed using a logistic regression model and a receiver operating characteristic curve.
RESULTS
In total, 305 patients were enrolled in this study. Of these, 129 (42.3%) patients presented with AKI, and 176 (57.7%) patients were unremarkable. The SII (odds ratio [OR], 1.261; 95% confidence interval [CI], 1.036-1.553; P = 0.020) values and serum uric acid levels (OR, 1.004; 95% CI, 1.001-1.007; P = 0.005) were significant predictors of AKI after SCH craniotomy. The SII cutoff value was 1794.43 (area under the curve [AUC], 0.669; 95% CI, 0.608-0.730; P < 0.001; sensitivity, 65.9%; specificity, 65.1%). Of the patients with AKI, 95 and 34 achieved poor and good outcomes, respectively. SII values (OR, 2.667; 95% CI, 1.167-6.095; P = 0.020), systemic inflammation response index values (OR, 1.529; 95% CI, 1.064-2.198; P = 0.022), and Glasgow Coma Scale (GCS) scores on admission (OR, 0.593; 95% CI, 0.437-0.805; P = 0.001) were significant in the multivariate logistic regression analysis. The cutoff SII value was 2053.51 (AUC, 0.886; 95% CI, 0.827-0.946; P < 0.001; sensitivity, 78.9%; specificity, 88.2%).
CONCLUSIONS
The SII may predict AKI in patients with SCH who underwent craniotomy and may also predict the short-term prognosis of these patients.
背景
全身免疫炎症指数（SII）是癌症的一种新兴预后标志物。我们旨在探讨 SII 对接受开颅手术的自发性脑出血（SCH）患者急性肾损伤（AKI）及预后的预测能力。
方法
本研究纳入了 2014 年至 2021 年间接受开颅手术的 SCH 患者。分析了 SCH 后 AKI 的流行病学和预测因素。进一步探讨了 SCH 和 AKI 患者临床结局的预后因素。然后使用逻辑回归模型和受试者工作特征曲线对预后因素进行分析。
结果
本研究共纳入 305 例患者，其中 129 例（42.3%）患者出现 AKI，176 例（57.7%）患者无异常。SII（比值比[OR]，1.261；95%置信区间[CI]，1.036-1.553；P=0.020）值和血清尿酸水平（OR，1.004；95%CI，1.001-1.007；P=0.005）是 SCH 开颅术后 AKI 的显著预测因素。SII 截断值为 1794.43（曲线下面积[AUC]，0.669；95%CI，0.608-0.730；P<0.001；灵敏度，65.9%；特异性，65.1%）。在 AKI 患者中，95 例患者预后不良，34 例患者预后良好。SII 值（OR，2.667；95%CI，1.167-6.095；P=0.020）、全身炎症反应指数值（OR，1.529；95%CI，1.064-2.198；P=0.022）和入院时格拉斯哥昏迷量表（GCS）评分（OR，0.593；95%CI，0.437-0.805；P=0.001）在多变量逻辑回归分析中具有显著意义。截断 SII 值为 2053.51（AUC，0.886；95%CI，0.827-0.946；P<0.001；灵敏度，78.9%；特异性，88.2%）。
结论
SII 可预测接受开颅手术的 SCH 患者 AKI，并可预测这些患者的短期预后。
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