Systemic Immune-Inflammation Index Predicts Delayed Cerebral Vasospasm After Aneurysmal Subarachnoid Hemorrhage
Systemic Immune-Inflammation Index Predicts Delayed Cerebral Vasospasm After Aneurysmal Subarachnoid Hemorrhage
复制标题
DOI：
10.1093/neuros/nyab354
复制
发表时间：
2021-12-01
期刊：
影响因子：
4.8
通讯作者：
Testai, Fernando D.
中科院分区：
文献类型：
--
作者：
Geraghty, Joseph R.;Lung, Tyler J.;Testai, Fernando D.
背景技术背景：迟发性脑血管痉挛是蛛网膜下腔出血（SAH）的一种严重并发症，目的：探讨全身炎症反应与迟发性脑血管痉挛的关系。我们假设SII指数的早期升高是血管痉挛的独立预测因子。方法：我们回顾性分析了289例蛛网膜下腔出血患者迟发性脑血管痉挛的血管造影或超声证据。根据入院时的实验室数据计算SII指数[（中性粒细胞x血小板/淋巴细胞）/1000]，并根据患者是否发生血管痉挛进行二分。进行多变量Logistic回归和受试者工作特征（ROC）分析，以确定SII指数的能力，以预测发展的vasospassion.Results：共246例患者被纳入我们的研究，其中166（67.5%）开发血管造影或超声证据的脑血管痉挛。有血管痉挛的SAH患者入院时SII指数高于无血管痉挛的患者（P <0.001）。在单变量logistic回归分析中，白细胞、中性粒细胞、淋巴细胞、嗜中性粒细胞-淋巴细胞比率（NLR）和SII指数与血管痉挛相关。校正年龄、动脉瘤位置、糖尿病、高脂血症和改良Fisher量表后，SII指数仍然是血管痉挛的独立预测因子（比值比1386，P = .003）。ROC曲线分析显示，SII指数能准确区分发生脑血管痉挛的患者与未发生脑血管痉挛的患者（曲线下面积= 0.767，P <0.001）。结论：SII指数早期升高可独立预测蛛网膜下腔出血迟发性脑血管痉挛的发生。
BACKGROUND: Delayed cerebral vasospasm is a feared complication of aneurysmal subarachnoid hemorrhage (SAH).OBJECTIVE: To investigate the relationship of systemic inflammation, measured using the systemic immune-inflammation (SII) index, with delayed angiographic or sonographic vasospasm. We hypothesize that early elevations in SII index serve as an independent predictor of vasospasm.METHODS: We retrospectively reviewed the medical records of 289 SAH patients for angiographic or sonographic evidence of delayed cerebral vasospasm. SII index [(neutrophils x platelets/lymphocytes)/1000] was calculated from laboratory data at admission and dichotomized based on whether or not the patient developed vasospasm. Multivariable logistic regression and receiver operating characteristic (ROC) analysis were performed to determine the ability of SII index to predict the development of vasospasm.RESULTS: A total of 246 patients were included in our study, of which 166 (67.5%) developed angiographic or sonographic evidence of cerebral vasospasm. Admission SII index was elevated for SAH in patients with vasospasm compared to those without (P < .001). In univariate logistic regression, leukocytes, neutrophils, lymphocytes, neutrophil-lymphocyte ratio (NLR), and SII index were associated with vasospasm. After adjustment for age, aneurysm location, diabetes mellitus, hyperlipidemia, and modified Fisher scale, SII index remained an independent predictor of vasospasm (odds ratio 1386, P = .003). ROC analysis revealed that SII index accurately distinguished between patients who develop vasospasm vs those who do not (area under the curve = 0.767, P < .001).CONCLUSION: Early elevation in SII index can independently predict the development of delayed cerebral vasospasm in aneurysmal SAH.