炎症负担指数：新型全身炎症生物标志物与动脉瘤性蛛网膜下腔出血患者预后及院内并发症之间的关联
Inflammatory Burden Index: Association Between Novel Systemic Inflammatory Biomarkers and Prognosis as Well as in-Hospital Complications of Patients with Aneurysmal Subarachnoid Hemorrhage.
作者信息
Song Zhenshan, Lin Fa, Chen Yu, Li Tu, Li Runting, Lu Junlin, Han Heze, Li Ruinan, Yang Jun, Li Zhipeng, Zhang Haibin, Yuan Kexin, Wang Ke, Zhou Yunfan, Jia Yitong, Chen Xiaolin
机构信息
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.
Stroke Center, Beijing Institute for Brain Disorders, Beijing, People's Republic of China.
出版信息
J Inflamm Res. 2023 Sep 4;16:3911-3921. doi: 10.2147/JIR.S416295. eCollection 2023.
PURPOSE
Systemic inflammation plays an important role in the pathophysiology and progression of aneurysmal subarachnoid hemorrhage (aSAH). In this study, we aimed to investigate the association between a new biomarker, the inflammatory burden index (IBI) and the prognosis as well as in-hospital complications of aSAH patients.
PATIENTS AND METHODS
We analyzed data from patients with aSAH between January 2019 and September 2022 who were included in the LongTEAM (Long-term Prognosis of Emergency Aneurysmal Subarachnoid Hemorrhage) registry study. The IBI was formulated as C-reactive protein × neutrophils/lymphocytes. The unfavorable functional prognosis was assessed by the modified Rankin Scale (mRS). Receiver operating characteristic (ROC) curve analysis was conducted to determine the optimal cut-off values for IBI to distinguish the unfavorable functional prognosis. Multivariate logistic regression was applied to investigate the association between IBI and in-hospital complications. Propensity score matching was adjusted for imbalances in baseline characteristics to assess the effect of IBI on prognosis.
RESULTS
A total of 408 consecutive patients with aSAH enrolled in the study, of which 235 (57.6%) were female patients and the mean age was 55.28 years old. An IBI equal to 138.03 was identified as the best cut-off threshold to distinguish the unfavorable prognosis at 3 months (area under the curve [AUC] [95% CI] 0.637 [0.568-0.706]). ln IBI was independently associated with 3-month functional prognosis (OR [95% CI] 1.362 [1.148-1.615]; P<0.001), pneumonia (OR [95% CI] 1.427 [1.227-1.659]; P<0.001) and deep venous thrombosis (DVT). (OR [95% CI] 1.326 [1.124-1.564]; P=0.001). After propensity score matching (57:57), an increased proportion of patients with IBI ≥138.03 had a poor functional prognosis at 3 months and in-hospital complications including developed pneumonia and DVT.
CONCLUSION
In patients with aSAH, high IBI level at admission was associated with unfavorable functional prognosis as well as pneumonia and deep vein thrombosis.
目的
全身炎症在动脉瘤性蛛网膜下腔出血（aSAH）的病理生理学和进展中起重要作用。在本研究中，我们旨在探讨一种新的生物标志物——炎症负担指数（IBI）与aSAH患者预后及住院并发症之间的关联。
患者与方法
我们分析了2019年1月至2022年9月期间纳入LongTEAM（急诊动脉瘤性蛛网膜下腔出血的长期预后）注册研究的aSAH患者的数据。IBI计算公式为C反应蛋白×中性粒细胞/淋巴细胞。采用改良Rankin量表（mRS）评估不良功能预后。进行受试者操作特征（ROC）曲线分析以确定区分不良功能预后的IBI最佳临界值。应用多因素逻辑回归分析探讨IBI与住院并发症之间的关联。采用倾向得分匹配法调整基线特征的不平衡，以评估IBI对预后的影响。
结果
本研究共纳入408例连续的aSAH患者，其中女性患者235例（57.6%），平均年龄55.28岁。确定IBI等于138.03为区分3个月时不良预后的最佳临界阈值（曲线下面积[AUC][95%CI]0.637[0.568 - 0.706]）。ln IBI与3个月功能预后（比值比[OR][95%CI]1.362[1.148 - 1.615]；P<0.001）、肺炎（OR[95%CI]1.427[1.227 - 1.659]；P<0.001）和深静脉血栓形成（DVT）（OR[95%CI]1.326[1.124 - 1.564]；P = 0.001）独立相关。倾向得分匹配后（57:57），IBI≥138.03的患者在3个月时功能预后不良以及发生包括肺炎和DVT在内的住院并发症的比例增加。
结论
在aSAH患者中，入院时高IBI水平与不良功能预后以及肺炎和深静脉血栓形成相关。
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