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. 2022 Nov 2:13:995925.
doi: 10.3389/fneur.2022.995925. eCollection 2022.

The predictive role of systemic inflammation response index in the prognosis of traumatic brain injury: A propensity score matching study

Baojie Mao  1   2 , Lei Feng  1   2 , Dongdong Lin  2 , Yanfei Shen  3 , Jiangchun Ma  2 , Yuning Lu  1   2 , Rui Zhang  1   2 , Ming Wang  2 , Shu Wan  2
Affiliations

The predictive role of systemic inflammation response index in the prognosis of traumatic brain injury: A propensity score matching study

Baojie Mao et al. Front Neurol. .

Abstract

Background: We aimed to evaluate the predictive power of systemic inflammation response index (SIRI), a novel biomarker, to predict all-cause mortality in patients with traumatic brain injury (TBI) in the intensive care unit (ICU).

Methods: Clinical data were retrieved from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. Kaplan-Meier (KM) methods and cox proportional hazard models were performed to examine the association between SIRI and all-cause mortality. The predictive power of SIRI was evaluated compared to other leukocyte-related indexes including neutrophils, lymphocytes, monocytes and white blood cells (WBC) by the Receiver Operating Characteristic (ROC)curve for 30-day mortality. In addition, propensity score matching (PSM) was conducted to reduce confounding.

Results: A total of 350 TBI patients were enrolled overall in our study. The optimal cutoff point of SIRI was determined at 11.24 × 109/L. After 1:1 PSM, 66 matched pairs (132 patients) were generated. During the 30-day, in-hospital and 365-day follow-up periods, patients with low SIRI level were associated with improved survival (p < 0.05) compared with patients with high SIRI level. Cox regression analysis identified that higher SIRI values was an independent risk factor for all-cause mortality and results were stable on multiple subgroup analyses. Furthermore, ROC analysis indicated that the area under the curve of SIRI [0.6658 (95% Confidence Interval, 0.5630-0.7687)] was greater than that of neutrophils, monocytes, lymphocytes and WBC. The above results were also observed in the matched cohort.

Conclusion: It was suggested that TBI patients with high SIRI level would suffer from a high risk of 30-day, in-hospital and 365-day mortality. SIRI is a promising inflammatory biomarker for predicting TBI patients' prognosis with relatively better predictive power than other single indicators related to peripheral differential leukocyte counts.

Keywords: Medical Information Mart for Intensive Care-IV; all-cause mortality; propensity score matching (PSM); systemic inflammation response index (SIRI); traumatic brain injury (TBI).

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Study flow diagram in the present study.
Figure 2
Figure 2
The optimal cutoff value of SIRI.
Figure 3
Figure 3
Kaplan–Meier survival analysis plot for 30-day, 365-day survival and in-hospital in patients before PSM (A–C), and patients after PSM (D–F). SIRI, systemic inflammation response index; PSM, propensity score matching; group low (< 11.24 × 109/L); group high (≥11.24 × 109/L).
Figure 4
Figure 4
The receiver operating characteristic (ROC) curves of predictive value of inflammatory indexes for 30-day mortality in TBI before (A) and after (B) PSM.
See this image and copyright information in PMC

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References

    1. Jiang JY, Gao GY, Feng JF, Mao Q, Chen LG, Yang XF, et al. . Traumatic brain injury in China. Lancet Neurol. (2019) 18:286–95. 10.1016/S1474-4422(18)30469-1 - DOI - PubMed
    1. Corps KN, Roth TL, McGavern DB. Inflammation and neuroprotection in traumatic brain injury. JAMA Neurol. (2015) 72:355–62. 10.1001/jamaneurol.2014.3558 - DOI - PMC - PubMed
    1. Brazinova A, Rehorcikova V, Taylor MS, Buckova V, Majdan M, Psota M, et al. . Epidemiology of traumatic brain injury in Europe: a living systematic review. J Neurotrauma. (2021) 38:1411–40. 10.1089/neu.2015.4126 - DOI - PMC - PubMed
    1. Greve MW, Zink BJ. Pathophysiology of traumatic brain injury. Mt Sinai J Med. (2009) 76:97–104. 10.1002/msj.20104 - DOI - PubMed
    1. Jin Z, Wu Q, Chen S, Gao J, Li X, Zhang X, et al. . The associations of two novel inflammation indexes, SII and SIRI with the risks for cardiovascular diseases and all-cause mortality: a ten-year follow-up study in 85,154 individuals. J Inflamm Res. (2021) 14:131–40. 10.2147/JIR.S283835 - DOI - PMC - PubMed