Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), Wuhu, China; The Translational Research Institute for Neurological Disorders of Wannan Medical College, Wuhu, China.
Blood Transfusion Department, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), Wuhu, China.
World Neurosurg. 2024 Oct;190:e1081-e1086. doi: 10.1016/j.wneu.2024.08.066. Epub 2024 Aug 14.
Hemorrhagic moyamoya disease (HMMD) can result in poor outcomes. Serum biomarkers may play a significant role in predicting HMMD outcomes. This study retrospectively analyzed the correlation between serum biomarkers at the time of admission and outcomes for patients with HMMD.
We evaluated 270 patients with HMMD admitted to Yijishan Hopital of Wannan Medical College between July 2017 and April 2023. The patients were categorized into 2 groups according to their modified Rankin Scale scores at 3 months after discharge. Univariate and multivariate analyses were used to identify the associations between biomarkers and clinical outcomes. Receiver operating characteristic curves were obtained to investigate the potential of the biomarkers for predicting prognosis.
Of the 270 patients analyzed, 96 (35.6%) had unfavorable outcomes. The potential predictors were identified using the univariate analysis. The subsequent multivariate logistic regression analysis showed that the systemic inflammatory response index (SIRI) (odds ratio 0.86, 95% confidence interval 0.75-0.98, P = 0.028] and serum glucose to potassium ratio (GPR) (odds ratio 0.53, 95% confidence interval 0.38-0.76, P < 0.001) were independent risk factors of poor outcomes. The receiver operating characteristic analysis indicated that patients with a higher SIRI (≥2.12) and GPR (≥1.75) levels were more likely to have unfavorable outcomes.
An elevated GPR and SIRI at admission were associated with a poor clinical outcome at the 3-month follow-up for patients with HMMD. Therefore, these biomarkers could be considered in future management decisions for these patients.
出血性烟雾病（HMMD）可导致不良结局。血清生物标志物可能在预测 HMMD 结局方面发挥重要作用。本研究回顾性分析了入院时血清标志物与 HMMD 患者结局之间的相关性。
我们评估了 2017 年 7 月至 2023 年 4 月期间在皖南医学院弋矶山医院就诊的 270 例 HMMD 患者。根据出院后 3 个月的改良 Rankin 量表评分，将患者分为 2 组。采用单因素和多因素分析来确定标志物与临床结局之间的关联。获得受试者工作特征曲线以研究标志物预测预后的潜力。
在分析的 270 例患者中，96 例（35.6%）结局不良。单因素分析确定了潜在的预测因素。随后的多因素逻辑回归分析表明，全身炎症反应指数（SIRI）（比值比 0.86，95%置信区间 0.75-0.98，P=0.028] 和血清葡萄糖与钾比值（GPR）（比值比 0.53，95%置信区间 0.38-0.76，P<0.001）是不良结局的独立危险因素。受试者工作特征分析表明，SIRI（≥2.12）和 GPR（≥1.75）水平较高的患者更有可能出现不良结局。
入院时升高的 GPR 和 SIRI 与 HMMD 患者 3 个月随访时的不良临床结局相关。因此，这些标志物可在未来这些患者的管理决策中考虑。
