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Association between dynamic systemic immune-inflammation index and prognosis in patients with ischemic stroke receiving intravenous thrombolysis: A Single-center Cohort Study

internal-medicine
neurology

Abstract

Background: The systemic immune-inflammation index (SII) is a comprehensive inflammatory index that reflects an individual's immunity. After an acute ischemic stroke ( AIS ), the inflammatory level of the brain was dynamic. We aimed to demonstrate the association between dynamic SII and the prognosis of AIS at 3 months post recombinant tissue plasminogen activator ( rt-PA ).

Methods: We investigated 268 AIS receiving rt-PA. Blood samples were collected before thrombolysis and on days 1, 2, 3, and 5– 7 after thrombolysis. The SII was calculated as the platelet × neutrophil/lymphocyte, converted to lgSII. The distribution of lgSII was utilized by a group-based trajectory model. Logistic regression was used to analyze the association between dynamic lgSII levels and prognosis of AIS. The lgSII were incorporated into a nomogram model and used a receiver operating characteristic curve to estimate the discriminatory prowess.

Results: The level of lgSII got to the top after thrombolysis [ 24 ± 5 h ] and got to the bottom after thrombolysis [72 ± 5 h ]. Furthermore, the middle- and high-level dynamic lgSII group was associated with poor outcomes of AIS with rt-PA after 3 months ( OR = 5.372, 95%CI: 1.791 – 16.117; OR = 8.401, 95%CI: 1.523 – 46.329 ). The nomogram model constructed based on the lgSII on day 2, demonstrated a significant predictive capacity for the outcome of AIS ( C-statistic = 0.889, 95%CI: 0.847-0.931).

Conclusion: The dynamic trend of SII changes for AIS. Besides, the middle- and high-level dynamic SII is associated with poor prognosis of AIS treated with rt-PA. The nomogram provides a prediction of AIS outcomes.

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