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. 2023 Apr 17:16:1581-1593.
doi: 10.2147/JIR.S399371. eCollection 2023.

Systemic Immune-Inflammation Index and Long-Term Mortality in Patients with Stroke-Associated Pneumonia

Mengdi Xie #  1 , Kang Yuan #  2 , Xinyi Zhu #  2 , Jingjing Chen  3 , Xiaohao Zhang  4 , Yi Xie  2 , Min Wu  1 , Zhaojun Wang  2 , Rui Liu  2 , Xinfeng Liu  1   2   5
Affiliations

Systemic Immune-Inflammation Index and Long-Term Mortality in Patients with Stroke-Associated Pneumonia

Mengdi Xie et al. J Inflamm Res. .

Abstract

Background: Systemic immune inflammation has been investigated as a prognostic marker of different diseases. This study is designed to assess the association of systemic immune-inflammation index (SII) with long-term mortality of stroke-associated pneumonia (SAP) patients.

Methods: Patients aged ≥18 years with SAP were selected from the Nanjing Stroke Registry Program in China. We retrospectively evaluated systemic immune-inflammation response with SII and pneumonia severity with the pneumonia severity index and the confusion, uremia, elevated respiratory rate, hypotension, and aged 65 years or older score. To explore the correlation between SII and mortality in SAP patients, multivariable Cox regressions and competing risk regressions were conducted. Mediation analysis was also performed to assess the role of pneumonia severity.

Results: Among 611 patients in the SAP population, death occurred in 164 patients (26.8%) during the median follow-up of 3.0 (1.2-4.6) years. In multivariate analysis, higher SII scores could predict increased mortality in patients with SAP (adjusted hazard ratio 2.061; 95% confidence interval, 1.256-3.383; P = 0.004), and the association was mediated by pneumonia severity. Moreover, adding SII to traditional models improved their predictive ability for mortality.

Conclusion: Our study displayed that SII was characterized in SAP patients with different prognoses. Elevated SII scores increased the risk of mortality. Further research is required for the clinical practice of the index among SAP patients.

Keywords: China; mortality; stroke-associated pneumonia; systemic immune-inflammation index.

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Conflict of interest statement

The authors have declared no conflicts of interest with respect to the authorship or publication of this article.

Figures

Figure 1
Figure 1
Flow chart of patients enrollment.
Figure 2
Figure 2
Kaplan-Meier survival curves of mortality categorized by SII.
Figure 3
Figure 3
Time-dependent ROC curves at 1, 3, and 6 years for SII.
Figure 4
Figure 4
Association was fitted with restricted cubic spline with 4 knots (at 5th, 35th, 65th, 95th percentiles) adjusted for covariates included in model 3 in Table 3. The solid line represented the hazard ratio and the dashed lines represented the 95% confidence interval.
See this image and copyright information in PMC

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