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. 2021 May 20:16:877-886.
doi: 10.2147/CIA.S311047. eCollection 2021.

Systemic Immune-Inflammation Index Predicts 3-Month Functional Outcome in Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis

Yiyun Weng #  1 , Tian Zeng #  2   3 , Honghao Huang #  2   3 , Junli Ren  2   3 , Jianing Wang  2   3 , Chenguang Yang  2   3 , Wenjing Pan  2   3 , Jingyu Hu  2   3 , Fangyue Sun  2   3 , Xinbo Zhou  2   3 , Haojie Qiu  2   3 , Yufan Gao  2   3 , Beibei Gao  4 , Lifen Chi  3 , Guangyong Chen  3
Affiliations

Systemic Immune-Inflammation Index Predicts 3-Month Functional Outcome in Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis

Yiyun Weng et al. Clin Interv Aging. .

Abstract

Background and purpose: Systemic immune-inflammation index (SII), a novel inflammation index derived from counts of circulating platelets, neutrophils and lymphocytes, has been studied in developing incident cancer. However, the clinical value of SII in acute ischemic stroke (AIS) patients had not been further investigated. Therefore, we aimed to explore the association between SII and severity of stroke as well as 3-month outcome of AIS patients.

Methods: A total of 216 AIS patients receiving intravenous thrombolysis (IVT) and 875 healthy controls (HCs) were retrospectively recruited. Blood samples were collected within 24h after admission. Severity of stroke was assessed by the National Institute of Health stroke scale (NIHSS) scores on admission and poor 3-month functional outcome was defined as Modified Rankin Scale (mRS) > 2.

Results: SII levels in AIS patients were higher than in HCs. The cut-off value of SII is 545.14×109/L. Patients with SII > 545.14×109/L had higher NIHSS scores (median: 5 vs 9, p < 0.001), a positive correlation between SII and NIHSS was observed (rs = 0.305, p < 0.001). Multivariate logistic regression analyses showed that high SII was one of the independent risk factors for poor prognosis at 3 months of AIS patients (OR = 3.953, 95% CI = 1.702-9.179, p = 0.001). The addition of SII to the conventional prognostic model improved the reclassification (but not discrimination) of the functional outcome (net reclassification index 39.3%, p = 0.007).

Conclusion: SII is correlated with stroke severity at admission and can be a novel prognostic biomarker for AIS patients treated with IVT.

Keywords: inflammation; ischemic stroke; prognosis; systemic immune-inflammation index.

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Conflict of interest statement

Yiyun Weng, Tian Zeng and Honghao Huang are co-first authors for this study. We declare that we do not have any commercial or associative interest that represents a conflict of interest in connection with the work submitted.

Figures

Figure 1
Figure 1
Flow chart for patients’ selection.
Figure 2
Figure 2
Receiver operator characteristic curves for the prediction of 3-month poor outcome using systemic immune-inflammation index (SII).
Figure 3
Figure 3
The association between SII and NIHSS. (A) A positive correlation of SII with NIHSS scores (rs = 0.305, p < 0.001). The red solid straight line was produced by linear regression while the black dotted line represented curve fitting by third order polynomial (cubic). (B) Patients with NIHSS > 10 (n = 60) had a significant increase in SII compared to those with NIHSS ≤ 10 (n = 156) (p = 0.001).
Figure 4
Figure 4
mRS distribution at 3 months for high SII group vs low SII group. mRS, modified Rankin Scale; SII, systemic immune-inflammation index.
See this image and copyright information in PMC

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