Use of A Systemic Inflammatory Response Index to Predict Non-Traumatic Non-Aneurysmal Subarachnoid Hemorrhage Patient Outcomes

Yu, Tingting; Wang, Zhengyang

doi:10.1016/j.jstrokecerebrovasdis.2022.106863

Cited by 6 publications

(8 citation statements)

References 34 publications

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“…Two research studies employed a 1:1 propensity score matching (PSM) technique to equalize the impact of potential confounders, leading to the incorporation of 12,737 individuals in the analysis. 11 studies [ 10 , 16 , 24 – 26 , 28 – 30 , 32 , 34 , 39 ] focused on AIS, 11 studies focused on HS including 5 studies [ 9 , 31 , 33 , 36 , 42 ] focused on ICH, and 6 studies [ 14 , 15 , 27 , 37 , 38 , 41 ] focused on SAH. The SIRI cutoff range was between 0.77 and 6.48 (× 10 9 /L), while the duration of follow-up varied from hospitalization to one year post-discharge.…”

Section: Resultsmentioning

confidence: 99%

“…3 A). 12 studies [ 9 , 14 , 16 , 24 , 25 , 27 – 29 , 31 , 34 , 39 , 41 ] assessed functional outcomes using the mRS scale and reported the ORs and 95% CIs for SIRI and poor outcome, with 2 studies [ 24 , 41 ] considering SIRI as both a continuous and dichotomous variable. The meta-analysis of 7 studies [ 9 , 24 , 25 , 27 , 29 , 39 , 41 ] considering SIRI as a continuous variable showed that for each standard deviation increase in SIRI, the risk of poor outcome increased by 20% (OR 1.20, 95% CI 1.07–1.34, P = 0.001, I 2 = 66%, Fig.…”

Section: Resultsmentioning

confidence: 99%

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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%

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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“…However, other factors such as inflammation have also been shown to be useful predictors of poor outcome in patients with SAH. Systemic inflammatory response syndrome score has been found to be an independent prognostic factor of poor functional outcome following SAH as assessed by mRs scores [ 47 , 48 , 49 ]. Of the inflammatory predictors, elevated CSF chemokine levels and inflammatory mediators showed an association with an unfavorable clinical outcome after SAH [ 35 , 50 , 51 ].…”

Section: Discussionmentioning

confidence: 99%

Inflammatory Markers as Predictors of Shunt Dependency and Functional Outcome in Patients with Aneurysmal Subarachnoid Hemorrhage

et al. 2023

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The mechanisms underlying post-hemorrhagic hydrocephalus (PHH) development following subarachnoid hemorrhage (SAH) are not fully understood, which complicates informed clinical decisions regarding the duration of external ventricular drain (EVD) treatment and prevents the prediction of shunt-dependency in the individual patient. The aim of this study was to identify potential inflammatory cerebrospinal fluid (CSF) biomarkers of PHH and, thus, shunt-dependency and functional outcome in patients with SAH. This study was a prospective observational study designed to evaluate inflammatory markers in ventricular CSF. In total, 31 Patients with SAH who required an EVD between June 2019 and September 2021 at the Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark, were included. CSF samples were collected twice from each patient and analyzed for 92 inflammatory markers via proximity extension assay (PEA), and the prognostic ability of the markers was investigated. In total, 12 patients developed PHH, while 19 were weaned from their EVD. Their 6-month functional outcome was determined with the modified Rankin Scale. Of the 92 analyzed inflammatory biomarkers, 79 were identified in the samples. Seven markers (SCF, OPG, LAP TGFβ1, Flt3L, FGF19, CST5, and CSF1) were found to be predictors of shunt dependency, and four markers (TNFα, CXCL5, CCL20, and IL8) were found to be predictors of functional outcome. In this study, we identified promising inflammatory biomarkers that are able to predict (i) the functional outcome in patients with SAH and (ii) the development of PHH and, thus, the shunt dependency of the individual patients. These inflammatory markers may have the potential to be employed as predictive biomarkers of shunt dependency and functional outcome following SAH and could, as such, be applied in the clinic.

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“…SIRI has received a lot of attention recently because of its pivotal role in predicting patient outcomes in several diseases. [25][26][27] A retrospective multi-institutional cohort analysis indicated that SIRI was a strong and independent prognostic biomarker that reliably stratified limited-stage small-cell lung cancer patients into 2 cohorts with significantly different OS outcomes. [27] A study by Qi et al found that SIRI could be applied to predict the prognosis of patients with pancreatic adenocarcinomas who receive chemotherapy and patients with SIRI ≥ 1.8 had a shorter time to disease progression and OS.…”

Section: Discussionmentioning

confidence: 99%

“…[28] Yu et al reported that SIRI may be a new tool to predict the clinical outcomes of patients with non-traumatic non-aneurysmal subarachnoid hemorrhage in the early stages of the disease. [26] SOFA score has been shown to be an effective tool for assessing the prognosis of patients with sepsis. [29] A study showed that patients admitted with sepsis/septic shock had the highest SAPS II value.…”

Section: Discussionmentioning

confidence: 99%

The association and prognostic value of systemic inflammatory response index with short and long-term mortality in patients with sepsis

Ru,

Luo

2023

Medicine

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This study evaluated the association and prognostic significance of the systemic inflammation response index (SIRI) with mortality in sepsis. In this cohort study, the sepsis patients were retrieved from the Medical Information Mart for Intensive Care III (MIMIC-III) and MIMIC-IV intensive care unit (ICU) databases. SIRI was calculated by using the neutrophil, monocyte, and lymphocyte counts. The outcomes were 28-day mortality, 1-year mortality, and 28 days to 1-year mortality. The Cox proportional hazards model with a hazard ratio (HR) and a 95% confidence interval (CI) was used to investigate the association and prognostic value of SIRI with mortality in sepsis. Subgroup analyses of the associations of SIRI with 28-day and 1-year mortality in sepsis were based on age, gender, Simplified Acute Physiology Score II (SAPSII), Sequential Organ Failure Assessment (SOFA), and presence or absence of septic shock. The receiver operating characteristic (ROC) curve was used to compare the predictive performances of SIRI, SOFA and SAPS II for mortality in sepsis. Of the 4239 patients included, 1339 patients suffered from 28-day mortality, 2085 patients suffering from 1-year mortality, and 746 (25.72%) suffered from 28 days to 1-year mortality. High SIRI levels exhibited higher risks of 28-day mortality (HR: 1.15, 95% CI: 1.03–1.29, P = .010), 1-year mortality (HR: 1.14, 95% CI: 1.04–1.24, P = .003), and 28 days to 1-year mortality (HR: 1.16, 95% CI: 1.01–1.35, P = .047) in sepsis. A higher SIRI was reported related to 28-day mortality and 1-year mortality in sepsis patients with female gender, with SOFA < 8, with SAPS II < 44, and in sepsis patients without sepsis shock. The AUC of SIRS, SOFA, and SAPS II in predicting 28-day mortality in sepsis were 0.726, 0.591, and 0.644, respectively. The AUC of SIRI in predicting 1-year mortality in sepsis was 0.761, higher than the AUC values of SOFA and SAPS II. A higher AUC value of SIRI compared with SOFA, and SAPS II in predicting 28 days to 1-year mortality was observed. Elevated SIRI was associated with an increased risk of mortality in sepsis. SIRI is an independent prognostic biomarker of mortality in sepsis.

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Use of A Systemic Inflammatory Response Index to Predict Non-Traumatic Non-Aneurysmal Subarachnoid Hemorrhage Patient Outcomes

Cited by 6 publications

References 34 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 as Predictors of Shunt Dependency and Functional Outcome in Patients with Aneurysmal Subarachnoid Hemorrhage

The association and prognostic value of systemic inflammatory response index with short and long-term mortality in patients with sepsis

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