Predictive value of the dynamic systemic immune-inflammation index in the prognosis of patients with intracerebral hemorrhage: a 10-year retrospective analysis.

Background And Purpose: The systemic immune-inflammation index (SII) is a novel immune inflammatory marker which has been proven to have excellent predictive value for many diseases. The aim of this study was to investigate the predictive value of SII at different time points after admission for functional outcome at discharge in patients with intracerebral hemorrhage (ICH).

Methods: The clinical data of patients with ICH who were treated at a medical center for neurological diseases in China between October 2012 and April 2022 were analyzed in this retrospective study. The SII was calculated based on neutrophil×platelet/lymphocyte counts and collected within the first 14 days after admission to analyze the dynamic changes. Adverse outcome was defined as a modified Rankin Scale (mRS) score of 4-6 at discharge. The correlation between the SII and the outcome was assessed using univariate and multivariate logistic regression analyses. The ability of SII to predict outcome was evaluated by the area under the receiver operating characteristic (ROC) curve (AUC).

Results: A total of 1,569 patients with ICH were included, of whom 790 had adverse outcome (50.35%). The Univariate logistic regression analysis showed that SII at any time point within 14 days after admission was significantly associated with adverse outcome. In the multivariate logistic regression analysis, the SII within 7 days after admission was found to be an independent predictor of adverse functional outcome in ICH patients at discharge. The ROC curve demonstrated that compared to other time points, the SII on day 2 after admission exhibited stronger predictive power for the functional outcome of patients with ICH at discharge (AUC:0.733, 95%CI = 0.679-0.787) (sensitivity 47.09%, specificity 87.02%) (OR 1.074, 95%CI = 1.033-1.126,  = 0.001).

Conclusion: SII within 7 days after admission, especially on day 2, is independently associated with adverse functional outcome in ICH patients at discharge. This association could be utilized in clinical practice and warrants further investigation.