Diagnostic and Predictive Value of Novel Inflammatory Markers of the Severity of Acute Traumatic Spinal Cord Injury: A Retrospective Study

Zhou, Wu; Mao, Zelu; Wang, Zhihua; Zhu, Huaxin; Zhao, Yue; Zhang, Zhixiong; Zeng, Yanyang; Li, Meihua

doi:10.1016/j.wneu.2022.12.015

Cited by 12 publications

(9 citation statements)

References 33 publications

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“…In the field of orthopedics, inflammatory systemic biomarkers such as the Systemic Immune-inflammatory Index (SII) and geriatric nutritional indicators like the Geriatric Nutritional Risk Index (GNRI) have been employed to predict survival rates [ 30 , 31 ] and postoperative complication rates. Nonetheless, this study marks the pioneering use of the SII–GNRI score to forecast one-year mortality subsequent to surgical intervention for hip fractures, encompassing both femoral neck and intertrochanteric femoral fractures.…”

Section: Discussionmentioning

confidence: 99%

Combined Systemic Immune-inflammatory Index (SII) and Geriatric Nutritional Risk Index (GNRI) predict survival in elderly patients with hip fractures: a retrospective study

Zhou,

Huang,

Zhu

et al. 2024

J Orthop Surg Res

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Purpose The Systemic Immune-inflammatory Index (SII) and Geriatric Nutritional Risk Index (GNRI) have undergone comprehensive examination and validation in forecasting the outcomes of diverse medical conditions. Nevertheless, the correlation between the combined use of GNRI and SII metrics and hip fractures has yet to be elucidated. This study aimed to determine whether the amalgamation of SII and GNRI scores constitutes an independent prognostic factor for elderly patients with hip fractures. Methods We conducted a retrospective analysis of elderly patients admitted to our facility with hip fractures, encompassing both femoral neck and intertrochanteric fractures. Demographic information, experimental parameters, and postoperative complications were systematically recorded. The Geriatric Nutritional Risk Index (GNRI) and Systemic Immunoinflammatory Index (SII) were meticulously computed. Receiver operating characteristic (ROC) curves were generated, and optimal cutoff values for each parameter were determined. Subsequently, a multivariate Cox regression analysis was employed to assess the predictive utility of the SII–GNRI score in relation to 1-year postoperative mortality among elderly patients with hip fractures. Results In a study involving 597 patients, 90 of whom experienced mortality within 1 year, it was observed that the SII-GNRI score in the group of patients who passed away was significantly higher compared to the group that survived. Following a multifactorial adjustment, it was established that a high SII–GNRI score served as an independent predictor of 1-year all-cause mortality in older patients with hip fractures. In addition to the SII–GNRI score, factors such as length of hospital stay, CCI > 2, and blood transfusion were also identified as independent risk factors for survival. Notably, the incidence of postoperative complications in patients with high SII–GNRI scores was significantly greater than in patients with low scores. Conclusion The SII–GNRI score proves valuable in predicting the 1-year survival rate for elderly patients with hip fractures who have undergone surgery.

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Section: Discussionmentioning

confidence: 99%

Combined Systemic Immune-inflammatory Index (SII) and Geriatric Nutritional Risk Index (GNRI) predict survival in elderly patients with hip fractures: a retrospective study

Zhou,

Huang,

Zhu

et al. 2024

J Orthop Surg Res

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“…Acute TSCI triggers a systemic immune response in circulating white blood cells (WBCs). Research indicates that peripheral in ammatory response biomarkers, including WBCs and neutrophils, correlate with injury severity and can predict prognosis in patients with TSCI (9). Early circulating neutrophil counts might predict the long-term recovery potential after TSCI (10).…”

Section: Mri Variables and Peripheral In Ammatory Response Biomarkers...mentioning

confidence: 99%

MRI variables and peripheral inflammatory response biomarkers predict severity and prognosis in patients with acute cervical traumatic spinal cord injury

Ding,

Zhou,

Wang

et al. 2024

Preprint

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Objective: Traumatic spinal cord injury (TSCI) stands as one of the most profoundly damaging and debilitating conditions. This study aims to explore the potential of magnetic resonance imaging (MRI) variables and peripheral inflammatory indicators as promising biomarkers. It aims to understand their significance in evaluating the severity and predicting the prognosis of TSCI. Furthermore, the study aims to ascertain whether combining these indicators could enhance the accuracy of injury assessment and predictive prognostic ability. Methods: A multicentre retrospective cohort study was conducted to assess the severity and prognostic value of MRI variables and peripheral inflammatory response biomarkers in patients with acute cervicalTSCI. The study involved 374 patients with acute cervicalTSCI drawn from the First Affiliated Hospital of Nanchang University and the Second Affiliated Hospital of Nanchang University. The severity and prognosis of patients with acute cervical TSCI were assessed using the American Spinal Injury Association Impairment Scale (AIS). The correlation between MRI variables, peripheral inflammatory response biomarkers, admission severity, and the 1-year follow-up prognosis was analysed. Results: After the initial assessment using the AIS grading system, 169 (49.2%) patients fell into the non-severe category for cervical TSCI (AIS A–B), while 205 (50.8%) patients were classified as severe cases (AIS C–E). The MRI variables (intramedullary lesion length [IMLL], Brain and Spinal Injury Centre [BASIC], maximum spinal cord compression [MSCC], and maximum canal compromise [MCC]) and inflammatory response biomarkers (white blood cells [WBCs], neutrophils, and C-reactive protein [CRP]) exhibited a consistent decrease correlating with the severity grades noted upon admission. Among the 374 patients assessed, 147 (39.3%) experienced a poor prognosis, as indicated by the AIS grade during the 1-year follow-up. MRI variables and peripheral inflammatory response biomarkers declined in correspondence with the follow-up AIS grades. Sex (p <0.001), IMLL (p <0.001), MSCC (p<0.001), MCC (p <0.001), BASIC (p <0.001), WBC (p<0.001), neutrophils (p <0.001), and CRP (p <0.001) were statistically significant in predicting poor outcomes. Through multiple logistic regression analysis, BASIC score and CRP emerged as independent predictors of poor prognosis. Notably, the model combining the BASIC score and CRP yielded a larger area under the curve compared to models using only the BASIC score or CRP individually. Conclusions: The BASIC score and CRP are crucial biomarkers for evaluating the severity of cervical TSCI and predicting prognosis. Their combination proved to be a more robust determinant of injury severity and a better predictor of neurological recovery.

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“…Neurologic function assessments at admission and discharge were scored by using AIS grade. Based on our previous study (11), patients with AIS A-B were classi ed in the severe TSCI group, and patients with AIS C-E were classi ed in the nonsevere patients. Prognosis was based on the ordinal change in AIS grade after 6 months of discharge.…”

Section: Clinical Data Collectionmentioning

confidence: 99%

“…However, there is an increasing amount of evidence that the prognosis of patients with TSCI depends not only on AIS grade but also on other variables, including radiographic performance and biochemical markers (7)(8)(9)(10). Our previous study showed that circulating in ammatory markers (e.g., leukocytes and NLR) were associated with injury severity and predict prognosis of TSCI (11). Furthermore, the variables used for prognostic prediction should be available in a time-and cost-effective manner and as well as easily usable.…”

Section: Introductionmentioning

confidence: 99%

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Serum glucose/potassium ratio as a clinical risk factor for predicting the severity and prognosis of acute traumatic spinal cord injury

Zhou,

Liu,

Wang

et al. 2023

Preprint

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Objective Acute traumatic spinal cord injury (TSCI) can lead to poor prognosis, and clinical biomarkers have not been established to predict poor prognosis. This study aimed to determine the significance of serum glucose/potassium ratio (GPR) in evaluating TSCI severity and predicting prognosis. Methods An analysis of 520 clinical records of acute TSCI patients from January 2012 to June 2022 was conducted by the authors. The relationship between serum GPR and The American Spinal Injury Association Impairment Scale (AIS) grade 6-month post-trauma prognosis in addition to admission AIS grade was analyzed. In order to evaluate the discriminatory ability, a receiver operating characteristic curve was used. All methods were performed in accordance with the relevant guidelines and regulations. Results Based on the initial assessment of AIS grade, 256 (49.2%) patients were categorized into the severe TSCI group (AIS A-B), and there was a significant correlation between the severe TSCI group and serum GPR (p < 0.001). Serum GPR was reduced in an AIS grade-dependent manner (R=-0.540, p < 0.001). 262 (50.4%) patients were classified as poor prognosis according to the AIS grade at discharge. Serum GPR was also reduced in AIS grade in a discharge-dependent manner (R = -0.599, p < 0.001). It was significantly higher in the poor prognosis group compared to the good prognosis group (p < 0.001 ). Poor prognosis was significantly associated with sex(p = 0.009), severity of TSCI (p < 0.001), location of TSCI (p < 0.001), Surgical decompression(P < 0.018), body temperature (p < 0.001), heart rate (p < 0.001), systolic arterial pressure (SAP) (p < 0.001), diastolic arterial pressure (DAP) (p < 0.001), serum GPR (p < 0.001), serum glucose (p < 0.001), serum potassium (p < 0.001) and white blood cell (WBC) count (p = 0.003). Multivariate logistic regression analysis showed a significant correlation between poor prognosis and serum GPR (p = 0.023). The ROC analysis showed that the area under the curve (AUC) of serum GPR as a poor predictor of prognosis in TSCI patients was 0.842 (95% CI 0.808–0.875). Conclusion There was a significant relationship between serum GPR and admission injury severity and 6-month prognosis of acute TSCI patients. The serum GPR can be used to assess the severity of acute TSCI and predict the prognosis .

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Diagnostic and Predictive Value of Novel Inflammatory Markers of the Severity of Acute Traumatic Spinal Cord Injury: A Retrospective Study

Cited by 12 publications

References 33 publications

Combined Systemic Immune-inflammatory Index (SII) and Geriatric Nutritional Risk Index (GNRI) predict survival in elderly patients with hip fractures: a retrospective study

Combined Systemic Immune-inflammatory Index (SII) and Geriatric Nutritional Risk Index (GNRI) predict survival in elderly patients with hip fractures: a retrospective study

MRI variables and peripheral inflammatory response biomarkers predict severity and prognosis in patients with acute cervical traumatic spinal cord injury

Serum glucose/potassium ratio as a clinical risk factor for predicting the severity and prognosis of acute traumatic spinal cord injury

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