OBJECTIVE
To
investigate the relationship of systemic inflammation, measured using
the systemic immune-inflammation (SII) index, with delayed angiographic
or sonographic vasospasm. We hypothesize that early elevations in SII
index serve as an independent predictor of vasospasm.
METHODS
We
retrospectively reviewed the medical records of 289 SAH patients for
angiographic or sonographic evidence of delayed cerebral vasospasm. SII
index [(neutrophils × platelets/lymphocytes)/1000] was calculated from
laboratory data at admission and dichotomized based on whether or not
the patient developed vasospasm. Multivariable logistic regression and
receiver operating characteristic (ROC) analysis were performed to
determine the ability of SII index to predict the development of
vasospasm.
RESULTS
A
total of 246 patients were included in our study, of which 166 (67.5%)
developed angiographic or sonographic evidence of cerebral vasospasm.
Admission SII index was elevated for SAH in patients with vasospasm
compared to those without (P < .001). In univariate logistic
regression, leukocytes, neutrophils, lymphocytes, neutrophil-lymphocyte
ratio (NLR), and SII index were associated with vasospasm. After
adjustment for age, aneurysm location, diabetes mellitus,
hyperlipidemia, and modified Fisher scale, SII index remained an
independent predictor of vasospasm (odds ratio 1.386, P = .003).
ROC analysis revealed that SII index accurately distinguished between
patients who develop vasospasm vs those who do not (area under the
curve = 0.767, P < .001).
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