Li Shaojie, Li Hongjian, Qiu Weizhi, Wu Baofang, Wang Jiayin, Li Yasong, Gao Hongzhi
Department of Neurosurgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, 362000, People's Republic of China.
School of Medical Imaging, North Sichuan Medical College, Nanchong, 634700, People's Republic of China.
J Inflamm Res. 2025 Jan 16;18:667-679. doi: 10.2147/JIR.S505797. eCollection 2025.
Accurate identification of the risk of postoperative pneumonia (POP) in aneurysmal subarachnoid hemorrhage (aSAH) is essential for the implementation of stratified treatment. This study evaluated the relevance and utility of the Systemic Immuno-inflammatory Index (SII) and the Systemic Inflammatory Response Index (SIRI) in predicting pneumonia after aSAH.
Two hundred and forty patients undergoing aSAH intervention were included. Differences in SII and SIRI between patient groups were analyzed by propensity score matching (PSM). Receiver Operating Characteristic curves (ROC) were used to evaluate the predictive validity of SII and SIRI and to determine their predictive thresholds. The association of these indices with POP risk was assessed by multivariate logistic regression and restricted cubic spline (RCS), and subgroup analyses were performed.
The overall POP prevalence was 60%, with 37.5% males and 62.5% females. PSM analyses showed statistically significant differences between the two groups for SII (=0.032) and SIRI (P=0.02). They had a high predictive accuracy for predicting POP, with AUC values of 0.643 and 0.644, respectively. SII and SIRI were positively associated with the POP risk, independent of other confounders. Moreover, further sensitivity analysis and RCS supported the stability of this finding. Subgroup analyses showed that the relationship was stable across subgroups.
This study reveals the potential role of SII and SIRI in predicting the risk of postoperative pneumonia in patients with aSAH, and provides a strong basis for early identification and stratification of patients who are at high risk of postoperative pneumonia in aSAH.
准确识别动脉瘤性蛛网膜下腔出血（aSAH）患者术后肺炎（POP）的风险对于实施分层治疗至关重要。本研究评估了全身免疫炎症指数（SII）和全身炎症反应指数（SIRI）在预测aSAH后肺炎方面的相关性和实用性。
纳入240例接受aSAH干预的患者。通过倾向得分匹配（PSM）分析患者组间SII和SIRI的差异。采用受试者工作特征曲线（ROC）评估SII和SIRI的预测效度并确定其预测阈值。通过多因素逻辑回归和限制性立方样条（RCS）评估这些指标与POP风险的关联，并进行亚组分析。
POP的总体患病率为60%，男性占37.5%，女性占62.5%。PSM分析显示两组间SII（P=0.032）和SIRI（P=0.02）存在统计学显著差异。它们对POP的预测准确性较高，AUC值分别为0.643和0.644。SII和SIRI与POP风险呈正相关，独立于其他混杂因素。此外，进一步的敏感性分析和RCS支持了这一发现的稳定性。亚组分析表明各亚组间关系稳定。
本研究揭示了SII和SIRI在预测aSAH患者术后肺炎风险中的潜在作用，并为早期识别和分层aSAH术后肺炎高危患者提供了有力依据。
