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Association between higher systemic immune inflammation index (SII) and deep vein thrombosis (DVT) in patients with aneurysmal subarachnoid hemorrhage (aSAH) after endovascular treatment

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Abstract

Inflammation contributes to deep vein thrombosis (DVT) formation in patients with aSAH after endovascular treatment. The relationship between systemic immune-inflammatory index (SII) as an inflammatory marker and DVT formation remains unclear. Thus, this study aims to evaluate the association between SII and aSAH-associated DVT following endovascular treatment. We enrolled 562 consecutive patients with aSAH after endovascular treatment at three centers from January 2019 to September 2021. The endovascular treatments included simple coil embolization and stent-assisted coil embolization. Deep venous thrombosis (DVT) was assessed by Color Doppler ultrasonography (CDUS). Multivariate logistic regression analysis was used to establish the model. We assessed the association of the SII, neutrophil-to-lymphocyte ratio (NLR), the systemic inflammatory response index (SIRI), platelet-lymphocyte ratio (PLR), and DVT by using restricted cubic spline (RCS). ASAH-associated DVT was found in 136 (24.20%) patients. Based on the multiple logistic regression analysis, the correlation was found between aSAH-associated DVT and elevated SII (fourth quartile) (adjusted odds ratio = 8.20 [95% confidence interval, 3.76–17.92]; p < 0.001 [p for trend < 0.001]), elevated NLR (fourth quartile) (adjusted odds ratio = 6.94 [95% confidence interval, 3.24–14.89]; p < 0.001 [p for trend < 0.001]), elevated SIRI (fourth quartile) (adjusted odds ratio = 4.82 [95% confidence interval, 2.36–9.84]; p < 0.001 [p for trend < 0.001]), and elevated PLR (fourth quartile) (adjusted odds ratio = 5.49 [95% confidence interval, 2.61–11.57]; p < 0.001 [p for trend < 0.001]). The increased SII was correlated with the formation of aSAH-associated DVT after endovascular treatment.

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Data availability

We enrolled patients at three centers (Beijing Tiantan Hospital, Capital Medical University; Beijing Tongren Hospital, Capital Medical University; The Third Xiangya Hospital, Central South University) from January 2019 to September 2021. If necessary, we can provide the data set to the editor.

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Funding

This study was supported by the Natural Science Foundation of China (81771233, 82171290), Research and Promotion Program of Appropriate Techniques for Intervention of Chinese High-risk Stroke People (GN-2020R0007), BTH Coordinated Development-Beijing Science and Technology Planning Project (Z181100009618035), Beijing Municipal Administration of Hospitals’ Ascent Plan (DFL20190501), and Beijing Natural Science Foundation (19L2013; 22G10396).

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Author notes

  1. Yongkai Qin and Baorui Zhang contributed equally to this work.

Authors and Affiliations

  1. Department of Neurosurgery, The Third Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China

    Yongkai Qin, Siyuan Dong, Songfeng Zhao, Lang Liu &  ShenkunTang

  2. Department of Neurosurgery, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China

    Baorui Zhang, Shangfeng Zhao, Wei Wang & Jun Kang

  3. Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China

    Yan Miao

  4. Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China

    Zhongxue Wu & Aihua Liu

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  1. Yongkai Qin
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Contributions

Yongkai Qin, Aihua Liu, Jun Kang, and Zhongxue Wu conceived the study concept. Yongkai Qin, Baorui Zhang, Shangfeng Zhao, and Wei Wang participated in the design of the study. Yongkai Qin, Baorui Zhang, Siyuan Dong, Songfeng Zhao, Yan Miao, Shenkun Tang, and Lang Liu collected data. Siyuan Dong, Shangfeng Zhao, and Wei Wang analyzed and interpreted the data. Yongkai Qin, Baorui Zhang, Jun Kang, and Aihua Liu drafted and edited the manuscript. Aihua Liu, Baorui Zhang, Yongkai Qin, and Jun Kang had full access to all the data in the study and took responsibility for the data and the accuracy of the data analysis. All the authors approved the final manuscript.

Corresponding authors

Correspondence to Jun Kang or Aihua Liu.

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Informed consent was obtained for all participants. This study was approved by the centers review board (Beijing Tiantan Hospital, Capital Medical University; Beijing Tongren Hospital, Capital Medical University; The Third Xiangya Hospital, Central South University) and was in accordance with the principles of the Declaration of Helsinki.

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Qin, Y., Zhang, B., Zhao, S. et al. Association between higher systemic immune inflammation index (SII) and deep vein thrombosis (DVT) in patients with aneurysmal subarachnoid hemorrhage (aSAH) after endovascular treatment. Neurosurg Rev 46, 142 (2023). https://doi.org/10.1007/s10143-023-02048-7

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