Systemic Immune-Inflammation Index is a Prognostic Predictor for Patients With Acute Ischemic Stroke Treated With Intravenous Thrombolysis

Abstract

Objective: To investigate whether baseline systemic immune-inflammation index (SII) is associated with 3-month poor prognosis and early neurological outcomes in patients with acute ischemic stroke treated with intravenous thrombolysis. Patients and Methods: A total of 221 consecutive patients were enrolled in the retrospective study. The primary endpoints were poor functional outcomes or death at 3 months. Secondary endpoints were early neurological deterioration (END) or symptomatic intracerebral hemorrhage within 24 hours. Receiver operating characteristic curve analyses was performed to assess the overall discriminative ability of SII in predicting the 4 endpoints. We also performed the Spearman correlation test to evaluate the relationship between SII and stroke severity. Univariable and multivariable logistic regression analyses were performed to evaluate the associations between SII and endpoints. Results: The cutoff values of SII were 504.99×109/L for predicting a 3-month poor prognosis (sensitivity, 70.9% and specificity, 69.6%), 524.47×109/L for predicting 3-month death (sensitivity, 78.9% and specificity, 59.9%) and 504.99×109/L for predicting END (sensitivity, 70.7% and specificity, 62.6%), respectively. A positive association between SII and the National Institutes of Health Stroke Scale was observed (r s = 0.306, P < 0.001). Multivariable analyses indicated that SII was independently associated with 3-month poor prognosis [odds ratio (OR) = 5.384; 95% CI: 2.844-10.193; P < 0.001], 3-month death (OR = 2.592, 95% CI: 1.046-6.421, P = 0.040) and END (OR = 3.202, 95% CI: 1.796-5.707, P < 0.001). Conclusion: Increased baseline SII was associated with END and 3-month poor outcomes, and may act as a potential prognostic predictor for acute ischemic stroke patients treated with intravenous thrombolysis.

Optimizing early neurological deterioration prediction in acute ischemic stroke patients following intravenous thrombolysis: a LASSO regression model approach

“…In our study, we developed a comprehensive predictive model integrating various factors closely associated with END post-IVT in patients with AIS. This model incorporates traditional stroke risk factors, such as age ( Tschirret et al, 2018 ; Girot et al, 2020 ) and blood glucose levels ( Simonsen et al, 2016 ; Huang et al, 2018 ; Meng et al, 2023 ), alongside emerging indicators like SII ( Wei et al, 2023 ), providing a more holistic risk assessment. Specifically, the inclusion of past stroke history ( Li et al, 2020 ; Jin et al, 2023 ) is pivotal as it may indicate an underlying state of cerebral vascular health in patients.…”

“…In our study, we developed a comprehensive predictive model integrating various factors closely associated with END post-IVT in patients with AIS. This model incorporates traditional stroke risk factors, such as age (Tschirret et al, 2018;Girot et al, 2020) and blood glucose levels (Simonsen et al, 2016;Huang et al, 2018;Meng et al, 2023), alongside emerging indicators like SII (Wei et al, 2023), providing a more holistic 10.3389/fnins.2024.1390117…”

Prenatal and childhood air pollution exposure, cellular immune biomarkers, and brain connectivity in early adolescents

“…In both sexes, higher values of immune markers were correlated with differences in intracellular white matter microstructure in various tracts across the brain, albeit with different patterns seen in male and female adolescents. Higher SII, PLR, NLR, WBC, and lower LMR values are typically associated with poor health outcomes as they are often used in prognosis for cancer and stroke ( Li et al, 2021 , Lu et al, 2023 , Tian et al, 2022 , Wei et al, 2023 ). In female adolescents, higher SII and PLR were primarily related to greater intracellular directional diffusion in projection (i.e., left striatal to inferior frontal cortex) and association (i.e., bilateral frontal superior corticostriate tract) fibers.…”

Predictive role of ABCD2, ABCD3I, C-reactive protein, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and systemic immune-inflammation index in 90-day and long-term stroke after transient ischemic attack

“…However, few studies have investigated the role of these inflammatory parameters in predicting ischemic stroke after TIA. Moreover, as far as we know, there is no study investigating the efficacy of these parameters in predicting long-term stroke after TIA [7,8].…”