Xiao Huaming, Li Lei, Zhang Feng, Cheng Lei, Li Yang, Han Wenlan, Li Huanting, Fan Mingchao
Department of Neurosurgery, Weihai Central Hospital, The Affiliated Hospital of Qingdao University, Weihai, Shandong, China.
Department of Neurosurgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
Front Neurol. 2023 Jun 15;14:1190544. doi: 10.3389/fneur.2023.1190544. eCollection 2023.
Prolonged mechanical ventilation (PMV) has been proven as a risk factor for poor prognosis in patients with neurocritical illness. Spontaneous basal ganglia intracerebral hemorrhage (ICH) is one common subtype of hemorrhagic stroke and is associated with high morbidity and mortality. The systemic immune-inflammation index (SII) is used as a novel and valuable prognostic marker for various neoplastic diseases and other critical illnesses.
This study aimed to analyze the predictive value of preoperative SII for PMV in patients with spontaneous basal ganglia ICH who underwent surgical operations.
This retrospective study was conducted in patients with spontaneous basal ganglia ICH who underwent surgical operations between October 2014 and June 2021. SII was calculated using the following formula: SII = platelet count × neutrophil count/lymphocyte count. Multivariate logistic regression analysis and receiver operating characteristics curve (ROC) were used to evaluate the potential risk factors of PMV after spontaneous basal ganglia ICH.
A total of 271 patients were enrolled. Of these, 112 patients (47.6%) presented with PMV. Multivariate logistic regression analysis showed that preoperative GCS (OR, 0.780; 95% CI, 0.688-0.883; < 0.001), hematoma size (OR, 1.031; 95% CI, 1.016-1.047; < 0.001), lactic acid (OR, 1.431; 95% CI, 1.015-2.017; = 0.041) and SII (OR, 1.283; 95% CI, 1.049-1.568; = 0.015) were significant risk factors for PMV. The area under the ROC curve (AUC) of SII was 0.662 (95% CI, 0.595-0.729, < 0.001), with a cutoff value was 2,454.51.
Preoperative SII may predict PMV in patients with spontaneous basal ganglia ICH undergoing a surgical operation.
长期机械通气（PMV）已被证明是神经危重症患者预后不良的一个危险因素。自发性基底节脑出血（ICH）是出血性卒中的一种常见亚型，与高发病率和死亡率相关。全身免疫炎症指数（SII）被用作各种肿瘤疾病和其他危重症的一种新的、有价值的预后标志物。
本研究旨在分析术前SII对接受手术治疗的自发性基底节ICH患者发生PMV的预测价值。
本回顾性研究纳入了2014年10月至2021年6月期间接受手术治疗的自发性基底节ICH患者。SII采用以下公式计算：SII = 血小板计数×中性粒细胞计数/淋巴细胞计数。采用多因素logistic回归分析和受试者工作特征曲线（ROC）评估自发性基底节ICH后发生PMV的潜在危险因素。
共纳入271例患者。其中，112例患者（47.6%）出现PMV。多因素logistic回归分析显示，术前格拉斯哥昏迷量表（GCS）评分（比值比[OR]，0.780；95%置信区间[CI]，0.688 - 0.883；P < 0.001）、血肿大小（OR，1.031；95% CI，1.016 - 1.047；P < 0.001）、乳酸（OR，1.431；95% CI，1.015 - 2.017；P = 0.041）和SII（OR，1.283；95% CI，1.049 - 1.568；P = 0.015）是PMV的显著危险因素。SII的ROC曲线下面积（AUC）为0.662（95% CI，0.595 - 0.729，P < 0.001），截断值为2454.51。
术前SII可能预测接受手术治疗的自发性基底节ICH患者发生PMV。
