AUTHOR=Hou Yuyang , Fan Jingxin , Yuan Huisheng , Zheng Hu , Yang Hongkuan , Li Hua , Chen Rudong , Yu Jiasheng 

TITLE=Prognostic capacity of the systemic inflammation response index for functional outcome in patients with aneurysmal subarachnoid hemorrhage

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1054315

DOI=10.3389/fneur.2023.1054315

ISSN=1664-2295

ABSTRACT=Objective: We aimed to investigate the relationship between systemic inflammatory response index (SIRI) and functional outcome after aneurysmal subarachnoid hemorrhage (aSAH).
Method: A retrospective cohort study was performed involving all consecutive aSAH patients admitted to out institution. The modified Rankin Scale (mRS) score was performed to determine the functional outcomes of all patients at 3 months after aSAH. Results were categorized as favorable (mRS score 0-2) and unfavorable (mRS score 3-6). Univariate and multivariate logistic regressive analysis were utilized to identify the prognostic significance of SIRI. To minimize the effects of confounding factors, patients were stratified according to the optimal cut-off value of SIRI with propensity score matching (PSM). Further subgroup analysis were performed to verify the consistency of our findings. Pearson’s correlation analysis was used to assess the relationship between SIRI and severity of aSAH.
Results: In this study, 350 patients were enrolled and 126 (36.0%) of them suffering unfavorable outcomes. The SIRI of 5.36  109/L was identified as the optimal cut-off value. Two score-matched cohorts (n = 100 in each group) obtained from PSM with low SIRI and high SIRI were used for analysis. A significantly higher unfavorable functional outcome rate was observed in patients with high SIRI before and after PSM (p < 0.001 and 0.017, respectively). Multivariate logistic regression analysis demonstrated that SIRI value ≥ 5.36  109/L was an independent risk factor for poor outcomes (OR 3.27 95% CI 1.28-8.56, p = 0.016) after adjusted for possible confounders. Similar outcomes were discovered in the PSM cohort. In ROC analysis, the area under the curve (AUC) of SIRI was 0.774 which shown better predictive value than other inflammatory markers observed in previous similar studies. Pearson’s correlation analysis proved the positive association between SIRI and aSAH severity.
Conclusions: Elevated SIRI at admission is associated with worse clinical status and poorer functional outcome among patients with aSAH. SIRI is a useful inflammatory marker with prognostic value for function outcome after aSAH.