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

• Main Authors: Weng Y, Zeng T, Huang H, Ren J, Wang J, Yang C, Pan W, Hu J, Sun F, Zhou X, Qiu H, Gao Y, Gao B, Chi L, Chen G
• Format: Article
• Language: English
• Published: Dove Medical Press 2021-05-01
• Series: Clinical Interventions in Aging
• Subjects: systemic immune-inflammation index; ischemic stroke; inflammation; prognosis
• Online Access: https://www.dovepress.com/systemic-immune-inflammation-index-predicts-3-month-functional-outcome-peer-reviewed-fulltext-article-CIA

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 Chen3 1Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China; 2School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, People’s Republic of China; 3Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China; 4Department of Internal Medicine, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Guangyong ChenDepartment of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, No. 108 Wansong Road, Wenzhou, 325000, Zhejiang, People’s Republic of ChinaTel [phone]Fax [phone]Email [e-mail] ChiDepartment of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of ChinaEmail [e-mail] 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: systemic immune-inflammation index, ischemic stroke, inflammation, prognosis