The Clinical Value of Systemic Inflammatory Response Index and Inflammatory Prognosis Index in Predicting 3-Month Outcome in Acute Ischemic Stroke Patients with Intravenous Thrombolysis

Ma, Xin; Yang, Jie; Wang, Xiaolu; Wang, Xiang; Chai, Shuhong

doi:10.2147/ijgm.s384706

Cited by 13 publications

(15 citation statements)

References 47 publications

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“…The 22 studies included in this systematic review and meta-analysis were published between 2020 and 2023. Among them, 5 articles were prospective studies [ 25 , 29 , 31 , 33 , 42 ], and the remaining 17 articles [ 9 , 10 , 14 – 16 , 24 , 26 – 28 , 30 , 32 , 34 , 36 – 39 , 41 ] were retrospective studies. The studies were conducted in China ( n = 19, two studies were from the MIMIC database), Italy ( n = 1), and Korea ( n = 2), with a total of 12,931 patients included.…”

Section: Resultsmentioning

confidence: 99%

Systemic inflammation response index as a clinical outcome evaluating tool and prognostic indicator for hospitalized stroke patients: a systematic review and meta-analysis

Huang,

Zhang,

Feng

et al. 2023

Eur J Med Res

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Background Stroke, which is the main element of cerebrovascular disease (CVD), has become the foremost reason for death and disability on a global scale. The systemic inflammation response index (SIRI), a newly developed and comprehensive indicator, has demonstrated promise in forecasting clinical results for diverse ailments. Nevertheless, the uncertainty surrounding the assessment and prediction of clinical outcomes for stroke patients by SIRI persists, and the conflicting findings from the limited studies conducted on this matter further complicate the situation. Consequently, we performed a thorough systematic review and meta-analysis to explore the correlation between SIRI and the clinical results in individuals suffering from stroke. Methods This research was registered in PROSPERO and carried out following the PRISMA guidelines. A thorough investigation was carried out on PubMed, Embase, the Cochrane Library, Web of Science, and Scopus databases. Furthermore, we conducted a manual search in Chinese databases, such as China national Knowledge Infrastructure (CNKI), WanFang, VIP, and China Biology Medicine (CBM). We assessed the potential for bias in the studies included by utilizing the Newcastle–Ottawa Scale (NOS) tool. Adverse clinical outcomes were the main focus of the study, with secondary endpoints including mortality, the predictive value of SIRI, SIRI values across various endpoints, and clinical parameters associated with subarachnoid hemorrhage (SAH) in relation to low and high SIRI group. Results Following rigorous evaluation, a grand total of 22 investigations, encompassing a populace of 12,737 individuals, were considered suitable for incorporation in the final analysis. The findings from our meta-analysis indicate a strong and consistent correlation between elevated SIRI levels and adverse functional outcomes, irrespective of the method used to evaluate unfavorable outcomes. Furthermore, increased SIRI values have a strong correlation with mortality rates in both the short and long term. Besides, SIRI is a useful indicator of the severity of SAH. SIRI demonstrates strong predictive ability in identifying unfavorable outcomes and stroke-related pneumonia (SAP), as higher SIRI values are typically linked to negative endpoints. Nevertheless, the meta-analysis indicated that there was no significant increase in the risk of early neurological deterioration (END) and acute hydrocephalus (AHC) in high SIRI group when comparing to low SIRI. Conclusion This study could potentially pave the way for groundbreaking insights into the relationship between SIRI and stroke patient outcomes, as it appears to be the first meta-analysis to explore this association. Given the critical role of the inflammatory response in stroke recovery, closely monitoring patients with high SIRI levels could represent a promising strategy for mitigating brain damage post-stroke. Thus, further investigation into SIRI and its impact on clinical outcomes is essential. While our initial findings offer valuable insights into this area, continued research is necessary to fully elucidate the potential of SIRI, ideally through dynamic monitoring and large-scale, multi-center studies. Ultimately, this research has the potential to inform clinical decision-making and improve patient outcomes following stroke. Systematic review registration:https://www.crd.york.ac.uk/prospero/; Identifier CRD42023405221.

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Section: Resultsmentioning

confidence: 99%

Systemic inflammation response index as a clinical outcome evaluating tool and prognostic indicator for hospitalized stroke patients: a systematic review and meta-analysis

Huang,

Zhang,

Feng

et al. 2023

Eur J Med Res

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“…Moreover, we observed that neutrophil count is separately associated with poor neurological outcomes, but lymphocyte count does not have a statistically significant correlation with the outcome. New articles in this regard have investigated novel indices such as the Systemic Inflammatory Response Index and Inflammatory Prognostic Index and have found an association between these indices and the short-term prognosis of AIS 18…”

Section: Discussionmentioning

confidence: 99%

“…New articles in this regard have investigated novel indices such as the Systemic Inflammatory Response Index and Inflammatory Prognostic Index and have found an association between these indices and the short-term prognosis of AIS. 18 …”

Section: Discussionmentioning

confidence: 99%

Inflammatory markers and functional outcome score in different subgroups of ischaemic stroke: a prospective cohort study

Fakhari,

Poorsaadat,

Almasi-Hashiani

et al. 2024

BMJ Neurol Open

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BackgroundAcute ischaemic stroke (AIS) is a leading cause of disability and mortality worldwide. Determining subgroups and outcomes of AIS may lead to better treatment. We aimed to investigate the relationship between inflammatory markers and subgroups of AIS with further follow-up of patients in terms of functional outcome score.MethodsIn this prospective cohort study, we examined white cell count (WCC), neutrophil count, lymphocyte count, neutrophil-to-lymphocyte ratio (NLR), erythrocyte sedimentation rate (ESR) and qualitative C reactive protein (CRP), in the first 24 hours of patients’ admission. Patients were assigned to AIS subgroups as defined by the TOAST criteria. Then patients’ disability score was followed up after 3 and 6 months, using the modified Rankin Scale.ResultsWe included 217 patients with AIS. The mean age of participants was 72.07 years, and we included 92 women (42.4%). For the AIS subgroup, 83 (38.25%) patients had large artery atherosclerosis (LAA), 41 (18.89%) had cardioembolism and 62 (28.57) had small vessel obstruction. Neutrophil count and NLR showed a statistically significant difference in the subgroups of AIS and were highest in the ‘other’ subgroup of AIS (p<0.05). Lymphocyte count, ESR and qualitative CRP showed no statistically significant difference between subgroups (p>0.05). WCC, neutrophil count and NLR showed a positive correlation with functional outcomes (p<0.05), other markers did not correlate with outcomes (pp>0.05).ConclusionWe can conclude that neutrophil count and NLR are available inflammatory biomarkers for predicting outcomes and these two biomarkers are associated with AIS subgroups. However, ESR, qualitative CRP and lymphocyte count do not appear to be correlated with outcomes or subgroup of AIS.

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“…Current evidence suggests that IPI is related to CRP, NLR, and ALB (IPI=CRP×NLR/ALB). Albumin is the main protein in human blood, which maintains body nutrition and balances colloid osmotic pressure [20]. Albumin has many physiological functions, such as antioxidation, anti-in ammation, inhibition of platelet aggregation, and thrombus formation [21].…”

Section: Discussionmentioning

confidence: 99%

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

Liu

et al. 2023

Preprint

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Background and purpose This study aimed to explore the association between the systemic inflammatory index (SIRI), systemic immune-inflammatory index (SII), and inflammatory prognosis index (IPI) with the 90-day outcomes of patients with acute ischemic stroke (AIS) after intravenous thrombolysis. Methods 190 AIS patients who underwent intravenous thrombolysis from September 2019 to December 2022 were enrolled in the present study. The National Institutes of Health Stroke Scale (NIHSS) and modified Rankin score (mRS) were assessed in AIS patients who met the inclusion criteria before thrombolysis, immediately after thrombolysis, and at 90 days. Peripheral venous blood was collected within 24 hours after admission and used to assess the following parameters: neutrophil count, lymphocyte count, monocyte count, platelet count, average platelet volume, and albumin. Next, the SIRI, SII, and IPI values were calculated, respectively. 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, and SIRI 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 age, baseline NIHSS, neutrophil count, mRS, NLR, SIRI, IPI, and SII, while the lymphocyte count was lower. 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). The Mann-Whitney U test showed that the SIRI, SII, and IPI levels in patients with moderate and severe AIS were higher than in patients with mild AIS (P < 0.001). Univariate analysis showed that admission NIHSS, NLR, SIRI, SII, and IPI were significantly correlated with poor 90-day prognosis. Although age, smoking and drinking history, and underlying diseases were not significantly associated with prognosis, they were considered potential risk factors for AIS and included in the analysis as potential confounding factors. Using the optimal cut-off value determined by ROC analysis, multivariate logistic regression analysis revealed high SIRI, SII, and IPI values as independent risk factors for poor 90-day prognosis (OR = 2.867, 3.721, and 2.877, respectively). Conclusions High SIRI, IPI, and SII values are correlated with poor 90d outcomes in AIS patients undergoing intravenous thrombolysis.

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The Clinical Value of Systemic Inflammatory Response Index and Inflammatory Prognosis Index in Predicting 3-Month Outcome in Acute Ischemic Stroke Patients with Intravenous Thrombolysis

Cited by 13 publications

References 47 publications

Systemic inflammation response index as a clinical outcome evaluating tool and prognostic indicator for hospitalized stroke patients: a systematic review and meta-analysis

Systemic inflammation response index as a clinical outcome evaluating tool and prognostic indicator for hospitalized stroke patients: a systematic review and meta-analysis

Inflammatory markers and functional outcome score in different subgroups of ischaemic stroke: a prospective cohort study

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

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