Title:Association Between Systemic Immune-Inflammation Index and Symptomatic
Intracranial Hemorrhage in Acute Ischemic Stroke Patients Undergoing
Endovascular Treatment
Volume: 19
Issue: 1
Author(s): Yuan Yang, Ting Cui, Xueling Bai, Anmo Wang, Xuening Zhang, Jincheng Wan, Changyi Wang, Kun Lu, Fayun Hu*Bo Wu*
Affiliation:
- Center of Cerebrovascular Diseases, Department of Neurology, West China Hospital, Sichuan University, Chengdu
610041, Sichuan Province, China
- Center of Cerebrovascular Diseases, Department of Neurology, West China Hospital, Sichuan University, Chengdu
610041, Sichuan Province, China
Keywords:
Systemic immune-inflammation index, acute ischemic stroke, symptomatic intracranial hemorrhage, endovascular treatment, blood-brain barrier, complication.
Abstract:
Background/Objective: Systemic immune-inflammation index (SII) is a novel inflammatory
factor, which may be involved in the destruction of the blood-brain barrier (BBB) after
acute ischemic stroke (AIS); however, the association between SII and symptomatic intracranial
hemorrhage (sICH) in AIS patients undergoing endovascular treatment (EVT) remains unclear.
Methods: Patients with acute ischemic stroke due to large vessel occlusion (AIS-LVO) who underwent
EVT were consecutively enrolled. Blood samples were collected in the emergency room and
SII was calculated by neutrophils × platelets/lymphocytes. Participants were categorized into tertiles
according to admission SII. The main outcome was defined as the occurrence of sICH, following the
European Cooperative Acute Stroke Study III (ECASS-III) criteria.
Results: A total of 379 AIS-LVO patients with EVT were enrolled (median age = 71 years, 52.5%
males). The median baseline National Institutes of Health Stroke Scale (NIHSS) score was 15 (IQR,
12-18). The median of SII was 820.9 × 109/L (IQR, 473.1-1345.2). Forty-three (11.3%) patients
developed sICH. SII was found to be independently associated with sICH after EVT (adjusted odd
ratio (OR) = 1.005 (per 10 units increase); 95% confidence interval (CI): 1.002-1.008; p = 0.002).
Compared to patients in the lowest SII tertile, patients in the highest tertile had a higher risk of sICH
(adj-OR 3.379; 95% CI 1.302-8.768; p = 0.012). The risk of sICH increased with the increase of SII
in a dose-dependent manner (p for trend = 0.004). There was no interaction between potential modifiers
and SII on sICH.
Conclusion: Admission SII is positively associated with sICH in AIS-LVO patients treated with
EVT. These results need to be confirmed in future studies.
