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Systemic immune-inflammation index predicts the outcome after aneurysmal subarachnoid hemorrhage

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Abstract

Systemic inflammatory response is closely related to the pathogenesis and prognosis in critical patients. Recently, systemic immune-inflammation index (SII), an indicator of systemic inflammatory response, was proved to predict the outcome in cancerous and non-cancerous diseases. The aim of this study is to investigate the association between SII on admission and 6-month outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH). The clinical data and prognosis of 76 patients with aSAH were analyzed. The 6-month outcome was assessed by the modified Rankin scale(mRS). The unfavorable outcome was defined as mRS score ≥ 3. In addition, multivariate analysis was conducted to investigate factors independently associated with the favorable outcome. Receiver operating characteristic (ROC) curve analysis was undertaken to identify the best cut-off value of SII for the discriminate between favorable and unfavorable outcome in these patients. Thirty-six patients (47.4%) in our study had an unfavorable outcome (mRS ≥ 3) at 6 months, and twenty-four (66.7%) of them were in the high-SII group. A significantly higher SII on admission was observed in patients with unfavorable functional outcome at 6 months. Binary logistic regression analysis showed that there was an independent association between SII on admission and 6-month clinical outcome (adjusted OR = 4.499, 95%CI: 1.242–16.295, P < 0.05). The AUC of the SII for predicting unfavorable outcome was 0.692 (95% CI: 0.571–0.814, P < 0.05). Systemic immune-inflammation index (SII) could be a novel independent prognostic factor for aSAH patients at the early stage of the disease.

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Data availability

The data used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Code availability

Not applicable.

Abbreviations

aSAH:

Aneurysmal subarachnoid hemorrhage

AUC:

Area under the curve

ANC:

Absolute neutrophil counts

ALC:

Absolute lymphocyte counts

CT:

Computerized tomography

CTA:

Computerized tomography angiography

CNS:

Central nervous system

CI:

Confidence interval

DND:

Delayed neurological dysfunction

DSA:

Digital subtraction angiography

H–H grade:

Hunt and Hess grade

IA:

Intracranial aneurysm

mRS:

Modified Rankin scale

NLR:

Neutrophil-to-lymphocyte ratio

OR:

Odds ratios

PLR:

Platelet-to-lymphocyte ratio

PNI:

Prognostic nutrition index

PLT:

Platelet

PLC:

Platelet counts

ROC:

Receiver operating characteristics

SII:

Systemic immune-inflammation index

SD:

Standard deviation

WBC:

White blood cells

WFNS grade:

World Federation of Neurosurgical Societies grade

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Funding

This work was supported by the Kuanren Talents Program of the Second Affiliated Hospital of Chongqing Medical University (No. 201959), Chongqing Science and Health Joint Project (No. 2020GDRC006), and Venture and Innovation Support Program for Chongqing Overseas Returnees (No. CX2019156).

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Authors and Affiliations

  1. Department of Neurosurgery, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China

    Fushu Luo, Yutong Zhao, Mingjiang Sun, Qiuguang He, Rong Wen & Zongyi Xie

  2. Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China

    Yuanyou Li

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  1. Fushu Luo
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  7. Zongyi Xie
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Contributions

Author contributions to the study and manuscript preparation include the following: Conception and design: Fushu Luo, Yuanyou Li, Zongyi Xie. Acquisition of data: Yuanyou Li, Mingjiang Sun. Analysis and interpretation of data: Fushu Luo, Yuanyou Li, Yuantong Zhao. Drafting the article: Fushu Luo, Yuanyou Li. Critically revising the article: all authors. Reviewed submitted version of manuscript: all authors. Approved the final version of the manuscript for publication on behalf of all authors: Zongyi Xie. Study supervision: Zongyi Xie.

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Correspondence to Zongyi Xie.

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Luo, F., Li, Y., Zhao, Y. et al. Systemic immune-inflammation index predicts the outcome after aneurysmal subarachnoid hemorrhage. Neurosurg Rev 45, 1607–1615 (2022). https://doi.org/10.1007/s10143-021-01681-4

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