全身免疫炎症指数预测脑出血患者的预后

Systemic immune-inflammation index predicts the outcome of patients with intracerebral hemorrhage

目的评估全身免疫炎症指数(SII)对脑出血患者预后的预测价值。方法采用回顾性研究方法,纳入脑病科急性脑出血患者,收集所有患者的基线资料及入院24 h内的SII指数,根据出院改良Rankin(mRS)评分,分为预后良好组(mRS≤2分)、预后不良组(mRS>2分),采用独立样本t检验、Mann-Whitney U检验、多因素logistic回归分析和ROC曲线分析。结果共纳入320例脑出血患者,111例(34.7%)取得了良好预后,多因素logistic回归分析显示,入院出血量、NIHSS评分、SII是预后不良的独立危险因素(P<0.05)。ROC曲线分析显示,SII指数预测预后的曲线下面积0.785,95.0%可信区间(0.705~0.812,P<0.05),最佳截断值1383.94,特异度64.5%,敏感度79.2%。结论早期SII指数升高与脑出血患者出院时的不良预后高度相关,可用于脑出血患者预后的预测。

Objective To evaluate the prognostic value of systemic immune-inflammation(SII)index in patients with intracerebral hemorrhage.Methods Acute intracerebral hemorrhage patients were consecutively enrolled.Clinical date and SII index within 24 hours of admission were collected.According to the modified Rankin Score(mRS)at discharge,the patients were divided into good outcome group(mRS≤2)and poor outcome group(mRS>2).Independent sample t-test,Mann-Whitney U test,multivariable logistic regression analysis and ROC curve analysis were used.Results Among the 320 patients with ICH enrolled,111 patients(34.7%)had good outcome.According to multivariate logistic regression analysis,admission bleeding volume,NIHSS score,and SII index were significant predictors of poor outcome(P<0.05).According to ROC curve analysis,The area under the curve of SII index to predict poor outcome was 0.785(95%CI:0.705-0.812,P<0.05).When the cut-off value was set as 1383.94,the specificity was 64.5%and sensitivity was 79.2%.Conclusion The early increase of SII is highly correlated with the poor outcome of patients with intracerebral hemorrhage at discharge,which can be used to predict the outcome of patients with intracerebral hemorrhage.