Deans' stroke musings: Association of inflammatory burden index with prognosis as well as stroke-associated pneumonia in non-surgical patients with spontaneous intracerebral hemorrhage

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, July 21, 2025

Association of inflammatory burden index with prognosis as well as stroke-associated pneumonia in non-surgical patients with spontaneous intracerebral hemorrhage

Biomarkers DO ABSOLUTELY NOTHING FOR RECOVERY! For pneumonia maybe you want the vaccine if your doctor is competent enough to know about it.

You've known about this problem for a long time. SOLVE IT!

Just maybe this vaccine!

Pneumonia Vaccine (3 posts to July 2020)

11% Stroke-associated pneumonia (2 posts to October 2020)

Association of inflammatory burden index with prognosis as well as stroke-associated pneumonia in non-surgical patients with spontaneous intracerebral hemorrhage

Xinyu Wang^†

Lingqian He^†

QiQi Cui

Jiapeng Zhao

Juexian Song^*

Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China

Aim: To assessment the new biomarker, the inflammatory burden index (IBI) and their correlations with clinical outcome as well as stroke-associated pneumonia (SAP) of ICH patients.

Methods: Patients diagnosed as spontaneous intracranial hemorrhage (SICH) were retrospectively screened from December 2018 to December 2022. The IBI was formulated as C-reactive protein×neutrophils/lymphocytes. In addition, systemic-inflammatory indices including ratios of neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), platelet-to-lymphocyte (PLR),and patelet-to-neutrophil (PNR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) on admission also were calculated. The primary outcome measure was 90-day functional outcome and the occurrence of SAP, with an mRS 3–6 score representing a unfavorable outcome. We used ROC curves to evaluate the diagnostic value of these differences. Univariate and multivariable analyses was conducted to identify the factors independently associated with 3 months unfavorable functional outcomes and stroke-associated pneumonia.

Results: A total of 209 patients were enrolled, of which 144 (68.9%) had unfavorable 90-day functional outcome, and 89 (42.1%) ICH patients developed SAP. Elevated IBI is an independent predictor for both stroke-associated pneumonia (SAP) and unfavorable 3-month outcomes in acute ICH patients, and showed a good predictive ability for SAP (AUC = 0.811, p < 0.001) and poor prognosis at 3 months (AUC = 0.745, p < 0.001).

Conclusion: Inflammatory biomarker index (IBI) are predictive of 90-day functional outcome and the SAP occurrence in patients with ICH.

Introduction

Intracerebral hemorrhage (ICH) is a particularly devastating form of stroke. Although it represents merely 10–20% of all stroke cases, it accounts for approximately 44% of stroke-related mortality and 60–80% of survivors experience serious neurological impairment, underscoring its disproportionately high clinical impact (1, 2). Most survivors of ICH continue to face complications, stroke-associated pneumonia (SAP) is the most common devastating complication, with an incidence rate of 34.6%, which also have a significant impact on the patient’s overall prognosis (3). Therefore, it is essential to find an early screening strategy for diagnosis and prognosis prediction in ICH patients (4–6). The inflammatory response contributes to the ICH-induced secondary brain injury and is indispensable in the occurrence and progression of SAP (7).

Within hours to days following ICH, a series of inflammatory reactions around the hematoma contributes to secondary injuries and worsen the prognosis (8). Correspondingly, peripheral blood inflammatory biomarkers, as easily accessible markers, may help predict functional outcomes (9). Previous studies have found that systemic inflammatory indices such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and systemic inflammatory response index (SIRI) are correlated with the clinical outcomes and complications of intracerebral hemorrhage (ICH) patients (9–15). The Inflammatory Burden Index (IBI) is a novel inflammatory marker defined as C-reactive protein (CRP) multiplied by the neutrophil-to-lymphocyte ratio (NLR) (16–18). Reflecting the level of inflammatory burden in tumors, IBI has been proven to be a strong prognostic predictor for cancer patients and may be the optimal indicator among various systemic inflammation indicators.

Accordingly, in this study, we aimed to investigate the association between IBI and the prognosis as well as in-hospital complications of ICH patients. We also compared the prognostic performance of IBI with previously reported inflammatory biomarkers to determine their prognostic value.