Predictive value of systemic immune-inflammation index on early prognosis of patients with acute traumatic brain injury

doi:10.3877/cma.j.issn.2095-9141.2022.06.008

Abstract

Abstract:

Objective

To investigate the predictive value of systemic immune-inflammation index (SII) on the early prognosis of patients with acute traumatic brain injury (TBI).

Methods

Patients with acute TBI admitted to Critical Care Medicine Department of Xuzhou Central Hospital from January 2018 to December 2021 were selected as the research objects, and the clinical data, blood test indexes were collected and SII was calculated. Patients were followed up for 30 d and divided into good prognosis group (GOS 4-5) and poor prognosis group (GOS 1-3) according to GOS score. Independent risk factors for poor prognosis in patients with acute TBI were analysed using univariate and multi-factor Logistic regression, and the area under the curve (AUC) was calculated by plotting the subject operating characteristic (ROC) curve. The predictive value of SII on the prognosis of patients with acute TBI was analyzed. The optimal cut-off value of SII was calculated and divided into high and low value groups to assess the 30 d risk of death in both groups.

Results

A total of 164 patients with acute TBI were included, 84 (51.2%) in the good prognosis group and 80 (48.8%) in the poor prognosis group. There were no significant differences in age, sex, mean arterial pressure, heart rate, hemoglobin, leukocyte count, neutrophil count, monocyte count, platelet count and MLR between the good prognosis group and the poor prognosis group (all P>0.05); There were significant differences in lymphocyte count, neutrophil-to-lymphocyte ratio (NLR), platelet to lymphocyteratio ratio, systemic inflammation response index (SIRI) and SII among the groups (all P<0.05).The SII values were significantly higher in the poor prognosis group than in the good prognosis group, with a statistically significant difference (P<0.01). Multi-factor Logistic regression analysis showed that SII was an independent risk factor for poor prognosis in patients with acute TBI (OR=1.275, 95%CI: 1.123-1.448, P<0.01). ROC curve analysis showed that SII predicted poor prognosis with an AUC of 0.925 (95%CI: 0.874-0.960) , sensitivity 87.50% and specificity 82.14%, and its predictive value was better than that of NLR. The optimal cut-off value for SII was 15.95, with a statistically significant higher mortality in SII>15.95 group (39.5%) than in SII≤15.95 group (6.4%) (relative risk 1.547, 95%CI: 1.292-1.854).

Conclusion

SII is closely associated with early poor prognosis and mortality risk in patients with acute TBI. The higher the level of SII, the worse the short-term prognosis of patients and the higher the risk of death, and SII has a high predictive value for short-term adverse outcomes in patients with acute TBI.

Key words: Acute traumatic brain injury, Systemic immune-inflammatory index, Early prognosis

Su Yan, Bo Lu, Maoqin Li. Predictive value of systemic immune-inflammation index on early prognosis of patients with acute traumatic brain injury[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2022, 08(06): 356-360.

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References 20

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项目	预后良好组（n=84）	预后不良组（n=80）	t/χ²/Z值	P值
年龄（岁，±s）	56±16	58±14	0.938	0.563
男性[例（%）]	65（77）	65（81）	0.373	0.540
MAP（mmHg，±s）	99±14	101±18	2.115	0.091
HR（次/min，±s）	76±14	78±15	0.698	0.568
血红蛋白（g/dL，±s）	12.41±1.32	12.32±1.70	0.875	0.482
白细胞计数（×10⁹/L，±s）	13.77±6.00	16.26±6.03	0.544	0.684
中性粒细胞计数（×10⁹/L，±s）	10.81±4.89	13.86±5.32	0.512	0.717
淋巴细胞计数[×10⁹/L，M（Q1，Q3）]	1.81（0.98，2.38）	0.89（0.59，1.45）	7.812	<0.010
单核细胞计数[×10⁹/L，M（Q1，Q3）]	0.64（0.45，0.94）	0.74（0.44，1.23）	1.746	0.142
血小板计数（×10⁹/L，±s）	171.49±72.95	213.84±76.74	0.563	0.608
NLR[M（Q1，Q3）]	5.62（3.74，9.22）	13.55（10.29，19.62）	9.593	<0.010
PLR[M（Q1，Q3）]	96.55（53.93，133.15）	222.49（127.61，303.88）	12.372	<0.010
MLR（±s）	0.54±0.37	0.85±0.43	1.086	0.228
SIRI[×10⁹/L，M（Q1，Q3）]	3.57（2.42，5.74）	10.06（6.52，17.08）	9.805	<0.010
SII[×10⁹/L，M（Q1，Q3）]	10.42（6.54，14.86）	27.64（18.86，42.92）	10.791	<0.010

项目	预后良好组（n=84）	预后不良组（n=80）	t/χ²/Z值	P值
年龄（岁，±s）	56±16	58±14	0.938	0.563
男性[例（%）]	65（77）	65（81）	0.373	0.540
MAP（mmHg，±s）	99±14	101±18	2.115	0.091
HR（次/min，±s）	76±14	78±15	0.698	0.568
血红蛋白（g/dL，±s）	12.41±1.32	12.32±1.70	0.875	0.482
白细胞计数（×10⁹/L，±s）	13.77±6.00	16.26±6.03	0.544	0.684
中性粒细胞计数（×10⁹/L，±s）	10.81±4.89	13.86±5.32	0.512	0.717
淋巴细胞计数[×10⁹/L，M（Q1，Q3）]	1.81（0.98，2.38）	0.89（0.59，1.45）	7.812	<0.010
单核细胞计数[×10⁹/L，M（Q1，Q3）]	0.64（0.45，0.94）	0.74（0.44，1.23）	1.746	0.142
血小板计数（×10⁹/L，±s）	171.49±72.95	213.84±76.74	0.563	0.608
NLR[M（Q1，Q3）]	5.62（3.74，9.22）	13.55（10.29，19.62）	9.593	<0.010
PLR[M（Q1，Q3）]	96.55（53.93，133.15）	222.49（127.61，303.88）	12.372	<0.010
MLR（±s）	0.54±0.37	0.85±0.43	1.086	0.228
SIRI[×10⁹/L，M（Q1，Q3）]	3.57（2.42，5.74）	10.06（6.52，17.08）	9.805	<0.010
SII[×10⁹/L，M（Q1，Q3）]	10.42（6.54，14.86）	27.64（18.86，42.92）	10.791	<0.010

变量	β值	SE值	Wald χ²值	P值	OR值（95%CI）
淋巴细胞计数	-1.111	0.393	0.079	0.778	0.895（0.414~1.933）
NLR	0.161	0.074	4.694	0.030	1.174（1.015~1.358）
PLR	-0.005	0.005	0.984	0.321	0.995（0.984~1.005）
SIRI	-0.048	0.056	0.740	0.390	0.953（0.855~1.063）
SII	0.243	0.065	14.123	<0.001	1.275（1.123~1.448）

变量	β值	SE值	Wald χ²值	P值	OR值（95%CI）
淋巴细胞计数	-1.111	0.393	0.079	0.778	0.895（0.414~1.933）
NLR	0.161	0.074	4.694	0.030	1.174（1.015~1.358）
PLR	-0.005	0.005	0.984	0.321	0.995（0.984~1.005）
SIRI	-0.048	0.056	0.740	0.390	0.953（0.855~1.063）
SII	0.243	0.065	14.123	<0.001	1.275（1.123~1.448）

指标	截断值	AUC（95%CI）	Youde指数	敏感度（%）	特异度（%）	标准误
NLR	>9.29	0.867（0.805-0.915）	0.598	81.25	78.57	0.029
SII	>15.95	0.925（0.874-0.960）	0.696	87.50	82.14	0.020

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