Arslan Kadir, Sahin Ayca Sultan
University of Health Sciences, Kanuni Sultan Süleyman Training and Research Hospital, Department of Anesthesiology and Reanimation.
Tohoku J Exp Med. 2025 Mar 15;265(2):91-97. doi: 10.1620/tjem.2024.J094. Epub 2024 Sep 12.
Neuroinflammation plays an essential role in the pathogenesis of acute ischemic stroke (AIS). This study aims to investigate the predictive value of the systemic immune-inflammation index (SII) and systemic inflammatory response index (SIRI) on mortality and functional limitation in patients with critical AIS. Patients with critical AIS in a tertiary hospital's intensive care unit (ICU) between June 2020 and 2022 were retrospectively examined. Patients were classified according to their 28-day mortality (survivor and non-survivor group) and functional status (poor and good functional outcomes). The performances of SII and SIRI in predicting mortality and functional outcomes were compared. A total of 198 patients were included in the study. The median age of the entire population was 70 (56-86) years, and 52% (n = 103) were male. Coronary vascular disease/heart failure was found to be significantly higher in the mortality group (p = 0.025). While SII was found to be significantly higher in the mortality group (1,180 vs. 811, p = 0.038), SIRI did not show a significant difference (1.82 vs. 1.70, p = 0.257). SII and SIRI were significantly higher in the poor functional outcome group (p < 0.001 and p = 0.015). In the ROC analysis of the functional status prediction performances of SII and SIRI, the cut-off value of SII was ≥ 1,146, the area under the curve (AUC) = 0.645 (0.568-0.722), the cut-off value of SIRI was ≤ 2.54, AUC = 0.600 (0.520-0.680) was detected. SII helps predict 28-day mortality in patients with critical AIS. Both SII and SIRI can predict functional status at discharge.
神经炎症在急性缺血性卒中(AIS)的发病机制中起重要作用。本研究旨在探讨全身免疫炎症指数(SII)和全身炎症反应指数(SIRI)对重症AIS患者死亡率和功能受限的预测价值。对2020年6月至2022年期间某三级医院重症监护病房(ICU)的重症AIS患者进行回顾性研究。根据患者28天死亡率(存活组和非存活组)和功能状态(功能结局差和良好)进行分类。比较SII和SIRI在预测死亡率和功能结局方面的表现。本研究共纳入198例患者。总体人群的中位年龄为70(56 - 86)岁,52%(n = 103)为男性。发现死亡组中冠状动脉疾病/心力衰竭显著更高(p = 0.025)。虽然发现死亡组中SII显著更高(1180对811,p = 0.038),但SIRI未显示出显著差异(1.82对1.70,p = 0.257)。功能结局差的组中SII和SIRI显著更高(p < 0.001和p = 0.015)。在SII和SIRI功能状态预测表现的ROC分析中,SII的临界值为≥1146,曲线下面积(AUC) = 0.645(0.568 - 0.722),SIRI的临界值为≤2.54,检测到AUC = 0.600(0.520 - 0.680)。SII有助于预测重症AIS患者的28天死亡率。SII和SIRI均可预测出院时的功能状态。