Han Ying, Lin Nan
Department of Geriatrics, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, China.
Fujian Key Laboratory of Vascular Aging, Fujian Medical University, Fuzhou, 350001, China.
Neurol Ther. 2024 Oct;13(5):1431-1451. doi: 10.1007/s40120-024-00645-2. Epub 2024 Aug 9.
The systemic inflammatory response index (SIRI) is a novel indicator of systemic inflammation derived from the absolute counts of neutrophils, monocytes, and lymphocytes. The aim of this meta-analysis was to evaluate the association between SIRI and functional outcome in patients with acute ischemic stroke (AIS).
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed in this meta-analysis. Relevant cohort studies were retrieved by a search of electronic databases including PubMed, Web of Science, Embase, Wanfang, and China National Knowledge Infrastructure from database inception to February 9, 2024. A poor functional outcome was defined as a modified Rankin Scale ≥ 3 within 3 months after disease onset. A random-effects model was used to combine the data by incorporating the influence of between-study heterogeneity. The protocol of the meta-analysis was not prospectively registered in PROSPERO.
Fourteen cohort studies were included. Pooled results showed that a high SIRI at admission was associated with increased risk of poor functional outcome within 3 months (odds ratio [OR]: 1.57, 95% confidence interval: 1.39 to 1.78, p < 0.001; I = 0%). Results of the meta-regression analysis suggested that the cutoff for defining a high SIRI was positively related to the OR for the association between SIRI and the risk of poor functional outcome (coefficient = 0.13, p = 0.03), while other variables including sample size, mean age, severity of stroke at admission, percentage of men, current smokers, or patients with diabetes did not significantly modify the results. Subgroup analyses according to study design, main treatments, and study quality scores showed similar results.
A high SIRI may be associated with a poor functional outcome in patients after AIS.
全身炎症反应指数（SIRI）是一种源自中性粒细胞、单核细胞和淋巴细胞绝对计数的全身炎症新指标。本荟萃分析的目的是评估SIRI与急性缺血性卒中（AIS）患者功能结局之间的关联。
本荟萃分析遵循系统评价和荟萃分析的首选报告项目指南。通过检索电子数据库（包括PubMed、科学网、Embase、万方和中国知网），从数据库建立至2024年2月9日检索相关队列研究。功能结局不良定义为发病后3个月内改良Rankin量表评分≥3分。采用随机效应模型合并数据，纳入研究间异质性的影响。该荟萃分析方案未在国际前瞻性系统评价注册库（PROSPERO）中进行前瞻性注册。
纳入14项队列研究。汇总结果显示，入院时高SIRI与3个月内功能结局不良风险增加相关（比值比[OR]：1.57，95%置信区间：1.39至1.78，p<0.001；I²=0%）。荟萃回归分析结果表明，定义高SIRI的临界值与SIRI和功能结局不良风险之间关联的OR呈正相关（系数=0.13，p=0.03），而其他变量（包括样本量、平均年龄、入院时卒中严重程度、男性比例、当前吸烟者或糖尿病患者）并未显著改变结果。根据研究设计、主要治疗方法和研究质量评分进行的亚组分析显示了相似的结果。
AIS患者中高SIRI可能与功能结局不良相关。
