Systemic-inflammatory indices and clinical outcomes in patients with anterior circulation acute ischemic stroke undergoing successful endovascular thrombectomy
Wenbo Cao,
Yiming Song,
Xuesong Bai,
Bin Yang,
Long Li,
Xinyu Wang,
Yuxin Wang,
Wenxuan Chang,
Yanfei Chen,
Yabing Wang,
Jian Chen,
Peng Gao,
Liqun Jiao,
Xin Xu
Affiliations
Wenbo Cao
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China; China International Neuroscience Institute (China-INI), 45 Changchun Street, Beijing, 100053, China; Jinan Hospital of Xuanwu Hospital, Capital Medical University, 5106 Jingshi Road, Jinan, Shandong, 250100, China
Yiming Song
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China; China International Neuroscience Institute (China-INI), 45 Changchun Street, Beijing, 100053, China
Xuesong Bai
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China; China International Neuroscience Institute (China-INI), 45 Changchun Street, Beijing, 100053, China
Bin Yang
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China; China International Neuroscience Institute (China-INI), 45 Changchun Street, Beijing, 100053, China
Long Li
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China; China International Neuroscience Institute (China-INI), 45 Changchun Street, Beijing, 100053, China; Jinan Hospital of Xuanwu Hospital, Capital Medical University, 5106 Jingshi Road, Jinan, Shandong, 250100, China
Xinyu Wang
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China; China International Neuroscience Institute (China-INI), 45 Changchun Street, Beijing, 100053, China
Yuxin Wang
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China; China International Neuroscience Institute (China-INI), 45 Changchun Street, Beijing, 100053, China
Wenxuan Chang
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China; China International Neuroscience Institute (China-INI), 45 Changchun Street, Beijing, 100053, China
Yanfei Chen
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China; China International Neuroscience Institute (China-INI), 45 Changchun Street, Beijing, 100053, China
Yabing Wang
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China; China International Neuroscience Institute (China-INI), 45 Changchun Street, Beijing, 100053, China
Jian Chen
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China; China International Neuroscience Institute (China-INI), 45 Changchun Street, Beijing, 100053, China
Peng Gao
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China; China International Neuroscience Institute (China-INI), 45 Changchun Street, Beijing, 100053, China
Liqun Jiao
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China; China International Neuroscience Institute (China-INI), 45 Changchun Street, Beijing, 100053, China; Jinan Hospital of Xuanwu Hospital, Capital Medical University, 5106 Jingshi Road, Jinan, Shandong, 250100, China; Department of Interventional Neuroradiology, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China; Corresponding author. Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China.
Xin Xu
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China; China International Neuroscience Institute (China-INI), 45 Changchun Street, Beijing, 100053, China; Jinan Hospital of Xuanwu Hospital, Capital Medical University, 5106 Jingshi Road, Jinan, Shandong, 250100, China; Corresponding author. Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China.
Background: There is a lack of comprehensive profile assessment on complete blood count (CBC)-derived systemic-inflammatory indices, and their correlations with clinical outcome in patients with anterior circulation acute ischemic stroke (AIS) who achieved successful recanalization by endovascular thrombectomy (EVT). Methods: Patients with anterior circulation AIS caused by large vessel occlusion (AIS-LVO) were retrospectively screened from December 2018 to December 2022. Systemic-inflammatory indices including ratios of neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), platelet-to-lymphocyte (PLR), and platelet-to-neutrophil (PNR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregate inflammation systemic index (AISI) on admission and the first day post-EVT were calculated. Their correlations with symptomatic intracranial hemorrhage (sICH) and unfavorable 90-day functional outcome (modified Rankin Scale score of 3–6) were analyzed. Results: A total of 482 patients [65 (IQR, 56–72) years; 33 % female] were enrolled, of which 231 (47.9 %) had unfavorable 90-day outcome and 50 (10.4 %) developed sICH. Day 1 neutrophil and monocyte counts, NLR, MLR, PLR, SII, SIRI, and AISI were increased, while lymphocyte and PNR were decreased compared to their admission levels. In multivariate analyses, neutrophil count, NLR, SII, and AISI on day 1 were independently associated with 90-day functional outcome. Moreover, day 1 neutrophil count, NLR, MLR, PLR, PNR, SII, and SIRI were independently linked to the occurrence of sICH. No admission variables were identified as independent risk factors for patient outcomes. Conclusion: CBC-derived systemic-inflammatory indices measured on the first day after successful EVT are predictive of 90-day functional outcome and the sICH occurrence in patients with anterior circulation AIS-LVO.
