Association Between Systemic Inflammation Response Index And The Prognosis Of Acute Ischemic Stroke

Background: Recent studies have recognized the systemic inflammation response index(SIRI)as a useful index to indicate inflammation status and predict the prognosis of multiple diseases.Previous studies have revealed that inflammation plays an essential role in acute ischemic stroke(AIS).However,the relationship between SIRI and AIS prognosis is unclear.Our study aimed to investigate the association between SIRI and the prognosis of AIS.Methods: Our study recruited 287 consecutive patients with first-ever stroke within 72 hours after stroke.Demographic and clinical information was collected at baseline.The functional prognosis was assessed at 3 months after stroke onset using the modified Rankin Scale(m RS).A poor outcome was defined as m RS >2.SIRI was calculated as neutrophil count×monocyte count/lymphocyte count.Logistic analyses were employed to evaluate the correlation between SIRI and the prognosis of AIS.ROC analysis and reclassification analysis were introduced to estimate the value of SIRI to predict poor prognosis of AIS.Results: The patients with poor prognosis were account for 27.5% of all participants.After fully adjusting for all covariates,each standard deviation increment of SIRI caused58.9% additional risk for poor prognosis after AIS.When dividing SIRI into quartiles,the fourth quartile had a 6.152 times risk than the first quartile.Moreover,after adding SIRI into established clinical risk factors,AUC showed a significant improvement(0.829 VS 0.790,P for comparison =0.016).Consistently,category-free net reclassification index(NRI,0.761,95% CI: 0.517-1.004,P<0.001)and integrated discrimination index(IDI,0.093,95%CI: 0.0512-0.134,P<0.001)confirmed the improvement by SIRI to predict poor prognosis of AIS.Conclusion: The SIRI is an independent predictor for the prognosis of AIS,potentially allowing clinicians to optimize the treatment strategy and improve the prognosis of AIS.