Aierken Kadiyan, Ma Liang, Zhu Yu, Jin Xinyang, Zhu Yajie, Zhou Jiahui, Gao Jing, Zhao Hongling, Wang Tao, Li Shijun
Department of Cardiology, Central Hospital of Dalian University of Technology (Dalian Municipal Central Hospital), Dalian, China.
China Medical University, Shenyang, China.
Front Cardiovasc Med. 2025 Apr 7;12:1541762. doi: 10.3389/fcvm.2025.1541762. eCollection 2025.
This study aimed to explore the relationship between the systemic immune-inflammatory index (SII) and the probability of in-hospital mortality among acute ischemic stroke (AIS) with atrial fibrillation (AF) patients undergoing intravenous thrombolysis.
This single-center, retrospective observational study included individuals among AIS with AF who received intravenous thrombolysis. The SII is determined by taking the product of the platelet and neutrophil counts, followed by dividing this result by the lymphocyte count. In-hospital mortality was defined as a Modified Rankin Scale (mRS) score of 6 point. The investigation applied logistic regression models, along with subgroup, sensitivity, and receiver operating characteristic (ROC) curve analyses assessments, to explore the relationship between the SII and in-hospital mortality.
541 patients were included in this study, 50 (9.24%) of whom died during their hospital stay. Multifactorial logistic regression analyses using fully adjusted models, demonstrated that the SII is independently associated with the risk of in-hospital death. Patients with elevated SII levels experienced a significantly increased risk of in-hospital mortality, which was found to be 2.557 (95% CI: 1.154-5.665, = 0.021) times greater compared to those with lower SII levels. Through multivariate logistic regression analyses, a notable correlation between the SII and the probability of death during hospitalization was observed across various subgroups, including individuals aged ≤75 and >75years, women, patients with persistent AF, those receiving thrombolytic therapy, diabetic and nondiabetic patients, individuals with BMI ≥24 kg/m, and those with an admission National Institutes of Health Stroke Scale score ≤20 ( < 0.05). Two sensitivity analyses confirmed the robustness of this association from multiple perspectives ( < 0.05). ROC analysis demonstrated that the SII, the baseline model, and their combined model all showed strong predictive power for in-hospital mortality. Notably, the combined model outperformed the SII alone ( < 0.05). In addition, the predictive value of SII for in-hospital death was significantly higher than that of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR).
A significant association has been observed between the risk of in-hospital death among AIS with AF individual undergoing intravenous thrombolysis and the SII.
本研究旨在探讨全身免疫炎症指数（SII）与急性缺血性卒中（AIS）合并心房颤动（AF）患者静脉溶栓后院内死亡概率之间的关系。
本单中心回顾性观察研究纳入了接受静脉溶栓的AIS合并AF患者。SII通过血小板计数与中性粒细胞计数的乘积除以淋巴细胞计数来确定。院内死亡定义为改良Rankin量表（mRS）评分为6分。本研究应用逻辑回归模型以及亚组分析、敏感性分析和受试者工作特征（ROC）曲线分析评估，以探讨SII与院内死亡之间的关系。
本研究共纳入541例患者，其中50例（9.24%）在住院期间死亡。使用完全调整模型进行的多因素逻辑回归分析表明，SII与院内死亡风险独立相关。SII水平升高的患者院内死亡风险显著增加，发现其风险是SII水平较低患者的2.557倍（95%置信区间：1.154 - 5.665，P = 0.021）。通过多变量逻辑回归分析，在各个亚组中均观察到SII与住院期间死亡概率之间存在显著相关性，包括年龄≤75岁和>75岁的个体、女性、持续性AF患者、接受溶栓治疗的患者、糖尿病和非糖尿病患者、BMI≥24 kg/m²的个体以及入院时美国国立卫生研究院卒中量表评分≤20的个体（P < 0.05）。两项敏感性分析从多个角度证实了这种关联的稳健性（P < 0.05）。ROC分析表明，SII、基线模型及其联合模型对院内死亡均具有较强的预测能力。值得注意的是，联合模型的表现优于单独的SII（P < 0.05）。此外，SII对院内死亡的预测价值显著高于中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）。
在接受静脉溶栓的AIS合并AF患者中，观察到院内死亡风险与SII之间存在显著关联。
