Predictive value of the systemic immune–inflammation index for outcomes in large artery occlusion treated with mechanical thrombectomy—a single-center study
BackgroundThe systemic immune–inflammation index (SII) is a composite and easily available inflammation index, which can quantitatively reflect the degree of inflammation. This study aims to investigate the predictive value of admission SII for outcomes of large artery occlusion treated with mechani...
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Frontiers Media S.A.
2025-01-01
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| author | Ao Qian Longyi Zheng Hui He Jia Duan Shuang Tang Wenli Xing |
| author_facet | Ao Qian Longyi Zheng Hui He Jia Duan Shuang Tang Wenli Xing |
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| description | BackgroundThe systemic immune–inflammation index (SII) is a composite and easily available inflammation index, which can quantitatively reflect the degree of inflammation. This study aims to investigate the predictive value of admission SII for outcomes of large artery occlusion treated with mechanical thrombectomy (MT).MethodsThis retrospective study was conducted at Suining Central Hospital, Sichuan, China. Patients were stratified into quartiles based on their SII. The investigating outcomes included hemorrhagic transformation (HT), malignant brain edema (MBE), 90-day functional outcome, and mortality. The adverse function was defined as the modified Rankin Scale (mRS) score > 2 at the 90-day follow-up. Multivariate analysis was performed to explore the relationships between SII and outcomes. In addition, cases (distinguished from the aforementioned patients) treated with MT + mild hypothermia (MH) were also included to elucidate the relationships between SII/MH and outcomes in a new cohort.ResultsA total of 323 patients treated with MT were included. The observed HT, MBE, adverse function, and mortality rates were 31.9, 25.7, 59.4, and 27.9%, respectively. Multivariate analysis demonstrated that heightened SII was significantly related to HT (odds ratio [OR]: 1.061, 95% confidence interval [CI]: 1.035–1.086, p < 0.001), MBE (OR: 1.074, 95% CI: 1.045–1.103, p < 0.001), adverse function (OR: 1.061, 95% CI: 1.031–1.092, p < 0.001), and mortality (OR: 1.044, 95% CI: 1.018–1.070, p = 0.001), after adjusting sex, age, Glasgow Coma Scale (GCS) score at admission, initial National Institutes of Health Stroke Scale (NIHSS) score, baseline Alberta Stroke Program Early Computed Tomography Score (ASPECTS), present HMCAS, occluded vessel region, collateral score and successful revascularization. HT and MBE may partially account for patients with elevated SII’s adverse function and mortality. In addition, with the criterion of baseline ASPECTS ≤ 7, a total of 42 patients treated with MT + MH were enrolled to build up a new cohort combined with 72 patients treated with mere MT. The risk role of SII and protect effect of MH were identified for HT (SII—OR: 1.037, 95% CI: 1.001–1.074; MH—OR: 0.361, 95% CI: 0.136–0.957), MBE (SII—OR: 1.063, 95% CI: 1.019–1.109; MH—OR: 0.231, 95% CI: 0.081–0.653), and mortality (SII—OR: 1.048, 95% CI: 1.011–1.087; MH—OR: 0.343, 95% CI: 0.118–0.994).ConclusionElevated SII was related to HT, MBE, 90-day adverse function, and mortality after MT. The MH may improve prognosis under high inflammation status. |
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| institution | Kabale University |
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| spelling | doaj-art-34eacbef8c9d42159aa278f8d55538112025-01-29T05:21:25ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-01-011510.3389/fneur.2024.15165771516577Predictive value of the systemic immune–inflammation index for outcomes in large artery occlusion treated with mechanical thrombectomy—a single-center studyAo Qian0Longyi Zheng1Hui He2Jia Duan3Shuang Tang4Wenli Xing5Department of Cerebrovascular Disease, Suining Central Hospital, Suining, ChinaDepartment of Radiology, School of Medicine, Xiang’an Hospital of Xiamen University, Xiamen University, Xiamen, ChinaDepartment of Outpatient, Suining Central Hospital, Suining, ChinaDepartment of Cerebrovascular Disease, Suining Central Hospital, Suining, ChinaDepartment of Cerebrovascular Disease, Suining Central Hospital, Suining, ChinaDepartment of Cerebrovascular Disease, Suining Central Hospital, Suining, ChinaBackgroundThe systemic immune–inflammation index (SII) is a composite and easily available inflammation index, which can quantitatively reflect the degree of inflammation. This study aims to investigate the predictive value of admission SII for outcomes of large artery occlusion treated with mechanical thrombectomy (MT).MethodsThis retrospective study was conducted at Suining Central Hospital, Sichuan, China. Patients were stratified into quartiles based on their SII. The investigating outcomes included hemorrhagic transformation (HT), malignant brain edema (MBE), 90-day functional outcome, and mortality. The adverse function was defined as the modified Rankin Scale (mRS) score > 2 at the 90-day follow-up. Multivariate analysis was performed to explore the relationships between SII and outcomes. In addition, cases (distinguished from the aforementioned patients) treated with MT + mild hypothermia (MH) were also included to elucidate the relationships between SII/MH and outcomes in a new cohort.ResultsA total of 323 patients treated with MT were included. The observed HT, MBE, adverse function, and mortality rates were 31.9, 25.7, 59.4, and 27.9%, respectively. Multivariate analysis demonstrated that heightened SII was significantly related to HT (odds ratio [OR]: 1.061, 95% confidence interval [CI]: 1.035–1.086, p < 0.001), MBE (OR: 1.074, 95% CI: 1.045–1.103, p < 0.001), adverse function (OR: 1.061, 95% CI: 1.031–1.092, p < 0.001), and mortality (OR: 1.044, 95% CI: 1.018–1.070, p = 0.001), after adjusting sex, age, Glasgow Coma Scale (GCS) score at admission, initial National Institutes of Health Stroke Scale (NIHSS) score, baseline Alberta Stroke Program Early Computed Tomography Score (ASPECTS), present HMCAS, occluded vessel region, collateral score and successful revascularization. HT and MBE may partially account for patients with elevated SII’s adverse function and mortality. In addition, with the criterion of baseline ASPECTS ≤ 7, a total of 42 patients treated with MT + MH were enrolled to build up a new cohort combined with 72 patients treated with mere MT. The risk role of SII and protect effect of MH were identified for HT (SII—OR: 1.037, 95% CI: 1.001–1.074; MH—OR: 0.361, 95% CI: 0.136–0.957), MBE (SII—OR: 1.063, 95% CI: 1.019–1.109; MH—OR: 0.231, 95% CI: 0.081–0.653), and mortality (SII—OR: 1.048, 95% CI: 1.011–1.087; MH—OR: 0.343, 95% CI: 0.118–0.994).ConclusionElevated SII was related to HT, MBE, 90-day adverse function, and mortality after MT. The MH may improve prognosis under high inflammation status.https://www.frontiersin.org/articles/10.3389/fneur.2024.1516577/fullacute ischemic strokelarge artery occlusionmechanical thrombectomysystemic immune-inflammation indexmild hypothermia |
| spellingShingle | Ao Qian Longyi Zheng Hui He Jia Duan Shuang Tang Wenli Xing Predictive value of the systemic immune–inflammation index for outcomes in large artery occlusion treated with mechanical thrombectomy—a single-center study Frontiers in Neurology acute ischemic stroke large artery occlusion mechanical thrombectomy systemic immune-inflammation index mild hypothermia |
| title | Predictive value of the systemic immune–inflammation index for outcomes in large artery occlusion treated with mechanical thrombectomy—a single-center study |
| title_full | Predictive value of the systemic immune–inflammation index for outcomes in large artery occlusion treated with mechanical thrombectomy—a single-center study |
| title_fullStr | Predictive value of the systemic immune–inflammation index for outcomes in large artery occlusion treated with mechanical thrombectomy—a single-center study |
| title_full_unstemmed | Predictive value of the systemic immune–inflammation index for outcomes in large artery occlusion treated with mechanical thrombectomy—a single-center study |
| title_short | Predictive value of the systemic immune–inflammation index for outcomes in large artery occlusion treated with mechanical thrombectomy—a single-center study |
| title_sort | predictive value of the systemic immune inflammation index for outcomes in large artery occlusion treated with mechanical thrombectomy a single center study |
| topic | acute ischemic stroke large artery occlusion mechanical thrombectomy systemic immune-inflammation index mild hypothermia |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2024.1516577/full |
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