The potential of systemic immune-inflammation index in predicting outcomes of facial palsy in patients with Ramsay Hunt syndrome treated by acupuncture

Yinglin Fang¹Xiaoping Zhong²Jing Zuo¹Jianlong Wang^1*

• ¹Xiaoshan Hospital of Traditional Chinese Medicine, Hangzhou, China
• ²Hangzhou Normal University, Hangzhou, China

Objective To investigate the association between the systemic immune-inflammation index (SII) and treatment outcomes of facial palsy in patients with Ramsay Hunt syndrome (RHS) receiving acupuncture therapy. Methods This retrospective observational study enrolled 125 adult patients diagnosed with RHS and treated with acupuncture at Hangzhou Xiaoshan Hospital of Traditional Chinese Medicine. Inclusion required clinical confirmation of RHS, baseline House–Brackmann (H-B) grade IV–VI facial palsy, and symptom onset within 7 days. Patients were categorized into effective (n = 85) and ineffective (n = 40) groups based on at least one-grade improvement in H-B score post-treatment. Baseline clinical and hematological parameters, including neutrophil, lymphocyte, and platelet counts, were collected to calculate SII: (platelet count × neutrophil count) / lymphocyte count. Statistical analyses included univariate and multivariate logistic regression, as well as receiver operating characteristic (ROC) curve analysis to assess the associative performance of SII and BMI. Results Compared with the effective group, the ineffective group exhibited significantly elevated neutrophil counts and SII, and reduced lymphocyte counts (all P < 0.05). Multivariate logistic regression identified SII as an independent factor associated with reduced likelihood of acupuncture efficacy (adjusted OR = 0.997, 95% CI: 0.995–0.998, P < 0.001), while BMI lost significance after adjustment. ROC analysis demonstrated a moderate discriminative ability of SII (AUC = 0.839, 95% CI: 0.765–0.913), with optimal sensitivity (70.0%) and specificity (89.4%) at a cut-off value of 1262.935. A combined model of SII and BMI showed only a marginal change in discriminative performance (AUC = 0.840, sensitivity = 85.9%, specificity = 72.5%). Conclusion SII is an independent biomarker associated with the clinical efficacy of acupuncture in patients with RHS-related facial palsy. Incorporating SII into clinical assessments may contribute to improved prognostic evaluation and support individualized therapeutic strategies.