SYSTEMATIC REVIEW article
Front. Neurol.
Sec. Neurological Biomarkers
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1594258
Prognostic Assessment of Acute Ischemic Stroke by Systemic Immune-inflammatory Index: A Comprehensive Meta-analysis of Multidimensional Outcomes
Provisionally accepted
- 1Shandong University of Traditional Chinese Medicine, Jinan, China
- 2Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
- 3Quzhou Hospital of Traditional Chinese Medicine, Quzhou, China
- 4Beijing University of Chinese Medicine, Beijing, Beijing Municipality, China
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Our study aimed to quantify the predictive ability of Systemic Immune-inflammatory Index(SII) for predicting the prognosis and multidimensional complications in Acute Ischemic Stroke(AIS) patients.The primary outcome was poor prognosis, and secondary outcomes included mortality, severity, Hemorrhagic Transformation/Symptomatic Intracerebral Hemorrhage, Stroke Associated Pneumonia/Poststroke Pneumonia, Early Neurological Deterioration, Post-stroke Depression, progression or recurrence, and other adverse outcomes. We searched 15 databases from their establishment to Oct 13, 2024 and selected cohort or case-control analyses that analyzed the association of continuous or categorized SII as exposures with above adverse outcomes of AIS populations.The results showed that 78 studies with 40682 participants were included in meta-analyses,continuous SII values were significantly higher in poor prognosis groups than in controls(SMD = 248.13,95%CI - 198.77 to 297.50; P = 0.000); poor prognosis incidences rose with higher continuous SII values(OR = 1.004,95% CI - 1.002 to 1.005; P = 0.000); more patients in High SII groups had poor prognosis (RR = 1.95,95%CI - 1.66 to 2.28; P = 0.000); the risk of poor prognosis was higher in the High SII groups(OR = 1.007,95%CI - 0.998 to 1.015; P = 0.120).In conclusion, our study found that continuous SII and high SII were associated with AIS's poor prognosis and various complications. Given SII's accessibility and low cost, integrating it into prognostic scores merits further research for better clinical choices.
Keywords: Acute ischemic stroke, Systemic immune-inflammatory index, Poor prognosis, prognostic biomarker, Meta-analysis
Received: 08 Apr 2025; Accepted: 29 Aug 2025.
Copyright: © 2025 Jiang, Cui, Hu, Lian, Qin, Wang and Ma. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xingchen Wang, Shandong University of Traditional Chinese Medicine, Jinan, China
Xuran Ma, Shandong University of Traditional Chinese Medicine, Jinan, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.