Skip to main content
SpringerLink
Log in

The prognostic value of systemic immune-inflammation index in patients with aneurysmal subarachnoid hemorrhage: a systematic review

  • Review
  • Published:
Neurosurgical Review Aims and scope Submit manuscript

Abstract

Aneurysmal subarachnoid hemorrhage (aSAH) is a devastating and life-threatening stroke subtype, that has a high disability and fatality rate. By the use of the systemic immune-inflammation index (SII), it is possible to understand the pathophysiology that underlies immune and inflammatory responses and anticipate consequences including delayed cerebral ischemia (DCI), delayed cerebral vasospasm, and functional outcome. A systematic search of the English-language literature in PubMed and Embase was performed to locate articles addressing the usage of SII in aSAH patients. The cutoff value, sensitivity, specificity, and area-under-the curve (AUC) of the receiver operating characteristic (ROC) curve were collected. Four publications were reviewed after applying the exclusion criteria from the 53 included articles. All the studies indicated that higher SII on admission was significantly associated with poor prognosis. The research examined in this paper provides the earliest indications that higher SII predicts DCI, delayed cerebral vasospasm, and functional outcome, even though other medical subspecialties have used this ratio for a long time to make such predictions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

Not applicable.

References

  1. Claassen J, Park S (2022) Spontaneous subarachnoid haemorrhage. Lancet (London, England) 400(10355):846–862. https://doi.org/10.1016/s0140-6736(22)00938-2

    Article  PubMed  Google Scholar 

  2. Macdonald RL, Schweizer TA (2017) Spontaneous subarachnoid haemorrhage. Lancet (London, England) 389(10069):655–666. https://doi.org/10.1016/s0140-6736(16)30668-7

    Article  PubMed  Google Scholar 

  3. Petridis AK, Kamp MA, Cornelius JF, Beez T, Beseoglu K, Turowski B, Steiger HJ (2017) Aneurysmal subarachnoid hemorrhage. Deutsch Arztebl Int 114(13):226–236. https://doi.org/10.3238/arztebl.2017.0226

    Article  Google Scholar 

  4. Kundra S, Mahendru V, Gupta V, Choudhary AK (2014) Principles of neuroanesthesia in aneurysmal subarachnoid hemorrhage. J Anaesthesiol Clin Pharmacol 30(3):328–337. https://doi.org/10.4103/0970-9185.137261

    Article  PubMed  PubMed Central  Google Scholar 

  5. Zhang P, Li Y, Zhang H, Wang X, Dong L, Yan Z, She L, Wang X, Wei M, Tang C (2020) Prognostic value of the systemic inflammation response index in patients with aneurismal subarachnoid hemorrhage and a Nomogram model construction. Br J Neurosurg 1–7. https://doi.org/10.1080/02688697.2020.1831438

  6. Yun S, Yi HJ, Lee DH, Sung JH (2021) Systemic inflammation response index and systemic immune-inflammation index for predicting the prognosis of patients with aneurysmal subarachnoid hemorrhage. J Stroke Cerebrovasc Dis: the official journal of National Stroke Association 30(8):105861. https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.105861

    Article  Google Scholar 

  7. Khey KMW, Huard A, Mahmoud SH (2020) Inflammatory pathways following subarachnoid hemorrhage. Cell Mol Neurobiol 40(5):675–693. https://doi.org/10.1007/s10571-019-00767-4

    Article  PubMed  Google Scholar 

  8. Hu B, Yang XR, Xu Y, Sun YF, Sun C, Guo W, Zhang X, Wang WM, Qiu SJ, Zhou J et al (2014) Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res: an official journal of the American Association for Cancer Research 20(23):6212–6222. https://doi.org/10.1158/1078-0432.ccr-14-0442

    Article  CAS  Google Scholar 

  9. Liang R, Li J, Tang X, Liu Y (2019) The prognostic role of preoperative systemic immune-inflammation index and albumin/globulin ratio in patients with newly diagnosed high-grade glioma. Clin Neurol Neurosurg 184:105397. https://doi.org/10.1016/j.clineuro.2019.105397

    Article  PubMed  Google Scholar 

  10. Qiu Y, Zhang Z, Chen Y (2021) Prognostic value of pretreatment systemic immune-inflammation index in gastric cancer: a meta-analysis. Front Oncol 11:537140. https://doi.org/10.3389/fonc.2021.537140

    Article  PubMed  PubMed Central  Google Scholar 

  11. Ye Z, Hu T, Wang J, Xiao R, Liao X, Liu M, Sun Z (2022) Systemic immune-inflammation index as a potential biomarker of cardiovascular diseases: a systematic review and meta-analysis. Front Cardiovasc Med 9:933913. https://doi.org/10.3389/fcvm.2022.933913

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Chen L, Pandey S, Shen R, Xu Y, Zhang Q (2021) Increased systemic immune-inflammation index is associated with delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage patients. Front Neurol 12:745175. https://doi.org/10.3389/fneur.2021.745175

    Article  PubMed  PubMed Central  Google Scholar 

  13. Stang A (2010) Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 25(9):603–605. https://doi.org/10.1007/s10654-010-9491-z

    Article  PubMed  Google Scholar 

  14. Geraghty JR, Lung TJ, Hirsch Y, Katz EA, Cheng T, Saini NS, Pandey DK, Testai FD (2021) Systemic immune-inflammation index predicts delayed cerebral vasospasm after aneurysmal subarachnoid hemorrhage. Neurosurgery 89(6):1071–1079. https://doi.org/10.1093/neuros/nyab354

    Article  PubMed  PubMed Central  Google Scholar 

  15. Luo F, Li Y, Zhao Y, Sun M, He Q, Wen R, Xie Z (2022) Systemic immune-inflammation index predicts the outcome after aneurysmal subarachnoid hemorrhage. Neurosurg Rev 45(2):1607–1615. https://doi.org/10.1007/s10143-021-01681-4

    Article  PubMed  Google Scholar 

  16. Osgood ML (2021) Aneurysmal subarachnoid hemorrhage: review of the pathophysiology and management strategies. Curr Neurol Neurosci Rep 21(9):50. https://doi.org/10.1007/s11910-021-01136-9

    Article  PubMed  Google Scholar 

  17. Chen L, Zhang Q (2020) Increased mean platelet volume is associated with poor outcome in patients with aneurysmal subarachnoid hemorrhage. World Neurosurg 137:e118–e125. https://doi.org/10.1016/j.wneu.2020.01.068

    Article  PubMed  Google Scholar 

  18. Jamali SA, Turnbull MT, Kanekiyo T, Vishnu P, Zubair AC, Raper CC, Tawk RG, Freeman WD (2020) Elevated neutrophil-lymphocyte ratio is predictive of poor outcomes following aneurysmal subarachnoid hemorrhage. J Stroke Cerebrovasc Dis: the official journal of National Stroke Association 29(4):104631. https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.104631

    Article  Google Scholar 

  19. Feghali J, Kim J, Gami A, Rapaport S, Caplan JM, McDougall CG, Huang J, Tamargo RJ, Jackson CM (2021) Monocyte-based inflammatory indices predict outcomes following aneurysmal subarachnoid hemorrhage. Neurosurg Rev 44(6):3499–3507. https://doi.org/10.1007/s10143-021-01525-1

    Article  PubMed  Google Scholar 

  20. Li X, Lin H, Ouyang R, Yang Y, Peng J (2021) Prognostic significance of the systemic immune-inflammation index in pancreatic carcinoma patients: a meta-analysis. Biosci Rep 41(8). https://doi.org/10.1042/bsr20204401

  21. Li X, Gu L, Chen Y, Chong Y, Wang X, Guo P, He D (2021) Systemic immune-inflammation index is a promising non-invasive biomarker for predicting the survival of urinary system cancers: a systematic review and meta-analysis. Ann Med 53(1):1827–1838. https://doi.org/10.1080/07853890.2021.1991591

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Li Y, Wen D, Cui W, Chen Y, Zhang F, Yuan M, Xiao H, Li H, Ma L, Hu X et al (2021) The prognostic value of the acute phase systemic immune-inflammation index in patients with intracerebral hemorrhage. Front Neurol 12:628557. https://doi.org/10.3389/fneur.2021.628557

    Article  PubMed  PubMed Central  Google Scholar 

  23. Li S, Liu K, Gao Y, Zhao L, Zhang R, Fang H, Tao Y, Liu H, Zhao J, Xia Z et al (2020) Prognostic value of systemic immune-inflammation index in acute/subacute patients with cerebral venous sinus thrombosis. Stroke Vasc Neurol 5(4):368–373. https://doi.org/10.1136/svn-2020-000362

    Article  PubMed  PubMed Central  Google Scholar 

  24. Hou D, Wang C, Luo Y, Ye X, Han X, Feng Y, Zhong P, Wu D (2021) Systemic immune-inflammation index (SII) but not platelet-albumin-bilirubin (PALBI) grade is associated with severity of acute ischemic stroke (AIS). Int J Neurosci 131(12):1203–1208. https://doi.org/10.1080/00207454.2020.1784166

    Article  CAS  PubMed  Google Scholar 

  25. Aggarwal A, Dhandapani S, Praneeth K, Sodhi HBS, Pal SS, Gaudihalli S, Khandelwal N, Mukherjee KK, Tewari MK, Gupta SK et al (2018) Comparative evaluation of H&H and WFNS grading scales with modified H&H (sans systemic disease): A study on 1000 patients with subarachnoid hemorrhage. Neurosurg Rev 41(1):241–247. https://doi.org/10.1007/s10143-017-0843-y

    Article  PubMed  Google Scholar 

  26. Darkwah Oppong M, Gembruch O, Pierscianek D, Köhrmann M, Kleinschnitz C, Deuschl C, Mönninghoff C, Kaier K, Forsting M, Sure U et al (2019) Post-treatment antiplatelet therapy reduces risk for delayed cerebral ischemia due to aneurysmal subarachnoid hemorrhage. Neurosurgery 85(6):827–833. https://doi.org/10.1093/neuros/nyy550

    Article  PubMed  Google Scholar 

  27. Nagahama Y, Allan L, Nakagawa D, Zanaty M, Starke RM, Chalouhi N, Jabbour P, Brown RD, Derdeyn CP, Leira EC et al (2018) Dual antiplatelet therapy in aneurysmal subarachnoid hemorrhage: association with reduced risk of clinical vasospasm and delayed cerebral ischemia. J Neurosurg 129(3):702–710. https://doi.org/10.3171/2017.5.jns17831

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Emergency, Sichuan Academy of Medical Sciences, Sichuan Provincial People’s Hospital, Chengdu, 610072, Sichuan, China

    Bingyao Liao

  2. Department of Neurosurgery, Sichuan Science City Hospital, Mianyang, 621000, Sichuan, China

    Qingyu Xu & Peng Lu

  3. Department of Geriatric, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, 621000, Sichuan, China

    Yunxia Zhang

Authors
  1. Bingyao Liao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Qingyu Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Peng Lu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yunxia Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the article and approved the submitted version. B. L.: conception, design of the manuscript, and wrote the main manuscript text. B. L., Q. X., P. L.: database search, literature review, and data extraction. Y. Z.: supervision and made critical revision of the manuscript for important intellectual content.

Corresponding author

Correspondence to Yunxia Zhang.

Ethics declarations

Ethical approval

This study did not require ethical approval.

Competing interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 17 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Liao, B., Xu, Q., Lu, P. et al. The prognostic value of systemic immune-inflammation index in patients with aneurysmal subarachnoid hemorrhage: a systematic review. Neurosurg Rev 46, 219 (2023). https://doi.org/10.1007/s10143-023-02133-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s10143-023-02133-x

Keywords

Search

Navigation