Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep 30;20(1):220.
doi: 10.1186/s12974-023-02890-y.

The relationship between systemic inflammation index, systemic immune-inflammatory index, and inflammatory prognostic index and 90-day outcomes in acute ischemic stroke patients treated with intravenous thrombolysis

Fei Ma #  1 , Lulu Li #  1 , Liang Xu  1 , Jiacheng Wu  2 , Aimei Zhang  1 , Junqi Liao  1 , Jingyi Chen  1 , Yunze Li  1 , Li Li  1 , Zhaoyao Chen  1 , Wenlei Li  1 , Qing Zhu  3 , Yuan Zhu  4 , Minghua Wu  5
Affiliations

The relationship between systemic inflammation index, systemic immune-inflammatory index, and inflammatory prognostic index and 90-day outcomes in acute ischemic stroke patients treated with intravenous thrombolysis

Fei Ma et al. J Neuroinflammation. .

Abstract

Background and purpose: To explore the association of systemic inflammatory index (SIRI), systemic immune-inflammatory index (SII) and inflammatory prognosis index (IPI) with 90d outcomes in patients with acute ischemic stroke (AIS) after intravenous thrombolysis.

Methods: The patients who underwent intravenous thrombolysis were enrolled in the present study from September 2019 to December 2022. According to the relevant blood indexes obtained in 24 h after admission, the corresponding values of SIRI, SII and IPI were calculated. The correlation among SIRI, SII, IPI, and admission NIHSS scores was examined by Spearman correlation analysis. ROC curve analysis was conducted to determine the optimal cut-off value of SIRI, SII, IPI, and their corresponding sensitivity and specificity to evaluate their predictive value on admission for poor prognosis. To investigate whether high SIRI, SII, and IPI were independent predictors of poor outcomes within 90 days, variables with P-value < 0.05 during univariate analysis were included in multivariate analysis.

Results: Compared with the good outcome group, the poor outcome group had higher SIRI, IPI, and SII. Spearman correlation analysis showed that the SIRI, IPI, and SII levels significantly correlated with the admission NIHSS score (r = 0.338, 0.356, 0.427, respectively; Ps < 0.001). Univariate analysis and Multivariate logistic regression analysis revealed high SIRI, SII, and IPI values as independent risk factors for poor 90-day prognosis (OR = 1.09, 1.003 and 7.109, respectively).

Conclusions: High SIRI, IPI, and SII values are correlated with poor 90d outcomes in AIS patients undergoing intravenous thrombolysis.

Keywords: Acute ischemic stroke; Inflammatory prognostic index; Intravenous thrombolysis; Systemic immune-inflammatory index; Systemic inflammatory index.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of patient selection. CHD: coronary heart disease; AF: atrial fibrillation; NIHSS: National Institutes of Health Stroke Scale; MPV: mean platelet volume; NLR: neutrophil-to-lymphocyte ratio; CRP: C-reactive protein; IPI: inflammatory prognosis index; SII: systemic immune-inflammation index; SIRI: system inflammation response index; RBG: random blood glucose
Fig. 2
Fig. 2
The differences between IPI, SII, and SIRI level and admission NIHSS Score. A Differences in IPI levels between two groups of AIS patients. B Differences in SII levels between two groups of AIS patients. C Differences in SIRI levels between two groups of AIS patients. IPI: inflammatory prognosis index; SII: systemic immune-inflammation index; SIRI: system inflammation response index; NIHSS: National Institutes of Health Stroke Scale
Fig. 3
Fig. 3
The violin plot of composite inflammatory ratios. The violin plot of the distribution of SIRI, IPI, and SII among different prognosis groups (P < 0.05). IPI: inflammatory prognosis index; SII: systemic immune-inflammation index; SIRI: system inflammation response index; NIHSS: National Institutes of Health Stroke Scale
Fig. 4
Fig. 4
The ROC value of SIRI, IPI, and SII in predicting poor short-term outcomes in AIS patients. The AUC of IPI was 0.701 with a sensitivity of 0.424 and a specificity of 0.873; the AUC of SII was 0.715 with a sensitivity of 0.879 and a specificity of 0.465; the AUC of SIRI was 0.720 with a sensitivity of 0.758 and a specificity of 0.618. IPI: inflammatory prognosis index; SII: systemic immune-inflammation index; SIRI: system inflammation response index
Fig. 5
Fig. 5
Kaplan–Meier survival curve for 90-day outcome in patients with AIS. A Kaplan–Meier survival curve for 90-day mortality in AIS patients according to SIRI; B Kaplan–Meier survival curve for 90-day mortality in AIS patients according to SII; C Kaplan–Meier survival curve for 90-day mortality in AIS patients according to IPI. Kaplan–Meier survival curve showed that SIRI > 1.298, SII > 392.903, and IPI > 0.223 were associated with a low risk of 90-day recurrence or mortality (P < 0.05). IPI: inflammatory prognosis index; SII: systemic immune-inflammation index; SIRI: system inflammation response index
See this image and copyright information in PMC

References

    1. Phipps MS, Cronin CA. Management of acute ischemic stroke. BMJ. 2020;368:l6983. doi: 10.1136/bmj.l6983. - DOI - PubMed
    1. Ma Q, Li R, Wang L, Yin P, Wang Y, Yan C, Ren Y, Qian Z, Vaughn MG, McMillin SE, et al. Temporal trend and attributable risk factors of stroke burden in China, 1990–2019: an analysis for the Global Burden of Disease Study 2019. Lancet Public Health. 2021;6:e897–e906. doi: 10.1016/S2468-2667(21)00228-0. - DOI - PMC - PubMed
    1. Cao X, Zhu Q, Xia X, Yao B, Liang S, Chen Z, Wu M. The correlation between novel peripheral blood cell ratios and 90-day mortality in patients with acute ischemic stroke. PLoS ONE. 2020;15:e0238312. doi: 10.1371/journal.pone.0238312. - DOI - PMC - PubMed
    1. Gong P, Liu Y, Gong Y, Chen G, Zhang X, Wang S, Zhou F, Duan R, Chen W, Huang T, et al. The association of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and lymphocyte to monocyte ratio with post-thrombolysis early neurological outcomes in patients with acute ischemic stroke. J Neuroinflamm. 2021;18:51. doi: 10.1186/s12974-021-02090-6. - DOI - PMC - PubMed
    1. Huang YW, Yin XS, Li ZP. Association of the systemic immune-inflammation index (SII) and clinical outcomes in patients with stroke: a systematic review and meta-analysis. Front Immunol. 2022;13:1090305. doi: 10.3389/fimmu.2022.1090305. - DOI - PMC - PubMed