Clinical Interventions in Aging (Dec 2021)
The Predictive Role of Systemic Inflammation Response Index (SIRI) in the Prognosis of Stroke Patients
Abstract
Yihui Zhang,1,2 Zekun Xing,3 Kecheng Zhou,1,2 Songhe Jiang1,2 1Rehabilitation Medicine Center, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People’s Republic of China; 2Intelligent Rehabilitation Research Center, China-USA Institute for Acupuncture and Rehabilitation, Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China; 3Neurology Department, Wencheng People’s Hospital, Wenzhou, Zhejiang, People’s Republic of ChinaCorrespondence: Songhe JiangRehabilitation Medicine Center, The Second Affiliated Hospital and Yuying Children’s Hospital, No. 109, West College Road, Wenzhou, Zhejiang, People’s Republic of ChinaEmail [email protected]: Stroke is a disease associated with high mortality. Many inflammatory indicators such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR) and red blood cell distribution width (RDW) have been documented to predict stroke prognosis, their predictive power is limited. A novel inflammatory indicator called systemic inflammatory response index (SIRI) has been advocated to have an essential role in the prognostic assessment of cancer and infectious diseases. In this study, we attempted to assess the prognosis of stroke by SIRI. Moreover, we compared SIRI with other clinical parameters, including NLR, PLR, LMR and RDW.Methods: This was a retrospective cohort study. We obtained data of 2450 stroke patients from the Multiparametric Intelligent Monitoring in Intensive Care III database. We used the Cox proportional hazards models to evaluate the relationship between SIRI and all-cause mortality and sepsis. Receiver operating curve (ROC) analysis was used to assess the predictive power of SIRI compared to NLR, PLR, LMR and RDW for the prognosis of stroke. We collected data of 180 patients from the First Affiliated Hospital of Wenzhou Medical University, which used the Pearson’s correlation coefficient to assess the relationship between SIRI and the National Institute of Health stroke scale (NIHSS).Results: After adjusting multiple covariates, we found that SIRI was associated with all-cause mortality in stroke patients. Rising SIRI accompanied by rising mortality. Besides, ROC analysis showed that the area under the curve of SIRI was significantly greater than for NLR, PLR, LMR and RDW. Besides, Pearson’s correlation test confirmed a significant positive correlation between SIRI and NIHSS.Conclusion: Elevated SIRI was associated with higher risk of mortality and sepsis and higher stroke severity. Therefore, SIRI is a promising low-grade inflammatory factor for predicting stroke prognosis that outperformed NLR, PLR, LMR, and RDW in predictive power.Keywords: systemic inflammation response index, stroke, NIHSS, mortality
