DIAGNOSTIC VALUE OF SYSTEMIC IMMUNE–INFLAMMATION INDEX (SIII) IN ACUTE ISCHEMIC STROKE

Yıl 2023, Cilt: 13 Sayı: 2, 187 - 192, 22.03.2023

Adem Çakır , Kemal Şener , Ramazan Güven

https://doi.org/10.16899/jcm.1213716

Cited By: 2

Öz

Background: Calculated based on platelet, neutrophil and lymphocyte counts, the systemic immune-inflammation index is thought to be associated with many malignancies in the literature. Despite the existing investigations on its diagnostic value, there have been no clear results reported regarding its diagnostic value in stroke patients. The current study is therefore intended to demonstrate the diagnostic value of the systemic immune-inflammation index and its prognostic value in cases of acute ischemic stroke.
Materials and Methods: A total of 150 cases of acute stroke and a control group of 150 individuals were retrospectively examined. The data recorded for each case included age, gender, history, vital findings, NIHSS, SIII, and outcome.
Results: In the current study, the group of stroke patients had significantly higher SIII than the control group. According to the diagnostic examinations, in stroke, the diagnostic value of SIII was greater than that of neutrophil-to-lymphocyte ratio at a statistically significant level. The present study also found that, compared to the SIII, the (Lymphocyte x Platelet)/Neutrophil ratio (called the novel SIII) had a higher statistical significance in diagnosing the stroke and predicting early hospital mortality.
Conclusions: The SIII can be a good marker for both diagnostic evaluation and for predicting early hospital mortality in stroke cases. Additionally, it is approved to be a useful index since it can be calculated inexpensively and easily.

Anahtar Kelimeler

Ischemic Stroke, Systemic immune-inflammation index, Emergency Department, Prognosis

AKUT İSKEMİK İNMEDE SİSTEMİK İMMÜN-İNFLAMASYON ENDEKSİNİN (SIII) TANISAL DEĞERLİLİĞİ

Öz

Giriş: Trombosit, nötrofil ve lenfosit sayılarına göre hesaplanan sistemik immün-enflamasyon indeksinin literatürde birçok malignite ile ilişkili olduğu düşünülmektedir. Tanısal değeri ile ilgili mevcut araştırmalara rağmen inme hastalarında tanısal değeri ile ilgili net sonuçlar bildirilmemiştir. Bu nedenle mevcut çalışma, akut iskemik inme vakalarında sistemik immün-enflamasyon indeksinin tanısal değerini ve bunun prognostik değerini göstermeyi amaçlamaktadır.
Gereç ve Yöntemler: Toplam 150 akut inme olgusu ve 150 kişilik kontrol grubu retrospektif olarak incelendi. Her vaka için kaydedilen veriler yaş, cinsiyet, öykü, hayati bulgular, NIHSS, SIII ve sonucu içeriyordu.
Bulgular: Mevcut çalışmada, inmeli hasta grubunda kontrol grubuna göre anlamlı olarak daha yüksek SIII vardı. Tanısal incelemelere göre inmede SIII'ün tanısal değeri nötrofil/lenfosit oranından istatistiksel olarak anlamlı düzeyde daha yüksekti. Bu çalışma ayrıca, SIII ile karşılaştırıldığında, (Lenfosit x Trombosit)/Nötrofil oranının (yeni SIII olarak adlandırılır) inme tanısında ve erken hastane mortalitesini tahmin etmede daha yüksek bir istatistiksel öneme sahip olduğunu bulmuştur.
Sonuçlar: SIII, inme vakalarında hem tanısal değerlendirme hem de erken hastane mortalitesini öngörmek için iyi bir belirteç olabilir. Ayrıca ucuz ve kolay hesaplanabilmesi nedeniyle faydalı bir parametre olduğunu düşünmekteyiz.

Anahtar Kelimeler

Ischemic Stroke, Systemic immune-inflammation index, Emergency Department, Prognosis

Kaynakça

• 1. Telefarlı MA, Akman C, Akdur O, et al. The effect of blood lactate level on prognosis in cerebrovascular disease. Ann Clin Anal Med 2020; DOI: 10.4328/ACAM.20171
• 2. Grønberg NV, Johansen FF, Kristiansen U, et al. Leukocyte infiltration in experimental stroke. J Neuroinflammation. 2013 Sep 18; 10:115. doi: 10.1186/1742-2094-10-115. PMID: 24047275; PMCID: PMC3852747.
• 3. Searls DE, Pazdera L, Korbel E, et al. Symptoms and signs of posterior circulation ischemia in the New England Medical Center Posterior Circulation Registry. Arch Neurol. 2012;69(3):346–351.
• 4. Wintermark M, Sanelli PC, Albers GW, et al. Imaging recommendations for acute stroke and transient ischemic attack patients: A joint statement by the American Society of Neuroradiology, the American College of Radiology, and the Society of NeuroInterventional Surgery. AJNR Am J Neuroradiol. 2013 Nov-Dec;34(11): E117-27. doi: 10.3174/ajnr. A3690. Epub 2013 Aug 1. PMID: 23907247; PMCID: PMC4072500.
• 5. Currie GM.Pharmacology, part 5: CT and MRI contrast media. J Nucl Med Technol 2019; 47: 189–202.
• 6. Jiang X, Andjelkovic AV, Zhu L, et al. Blood-brain barrier dysfunction and recovery after ischemic stroke. Prog Neurobiol. 2018 Apr-May;163-164:144-171. doi: 10.1016/j.pneurobio.2017.10.001. Epub 2017 Oct 5. PMID: 28987927; PMCID: PMC5886838.
• 7. Jayaraj RL, Azimullah S, Beiram R, et al. Neuroinflammation: friend and foe for ischemic stroke. J Neuroinflammation. 2019 Jul 10;16(1):142. doi: 10.1186/s12974-019-1516-2. PMID: 31291966; PMCID: PMC6617684.
• 8. Hu B, Yang XR, Xu Y, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res. 2014 Dec 1;20(23):6212-22. doi: 10.1158/1078-0432.CCR-14-0442. Epub 2014 Sep 30. PMID: 25271081.
• 9. Yang R, Chang Q, Meng X, et al. Prognostic value of systemic immune-inflammation index in cancer: a meta-analysis. J Cancer. 2018; 9:3295-3302.
• 10. Zhong JH, Huang DH, Chen ZY. Prognostic role of systemic immune-inflammation index in solid tumors: a systematic review and meta-analysis. Oncotarget. 2017;8: 75381-75388.
• 11. Clark RK, Lee EV, White RF, et al. Reperfusion following focal stroke hastens inflammation and resolution of ischemic injured tissue. Brain Res Bull. 1994;35(4):387-92. doi: 10.1016/0361-9230(94)90119-8. PMID: 7850491.
• 12. Li GZ, Zhong D, Yang LM, et al. Expression of interleukin-17 in ischemic brain tissue. Scand J Immunol 2005; 62:481–6. 16.
• 13. Zhang R, Wu X, Hu W, et al. Neutrophil-to-lymphocyte ratio predicts hemorrhagic transformation in ischemic stroke: A meta-analysis. Brain Behav 2019;9: e01382.
• 14. Iadecola C, Anrather J. The immunology of stroke: from mechanisms to translation. Nat Med 2011; 17:796-808.
• 15. Ali RA, Wuescher LM, Worth RG. Platelets: essential components of the immune system. Curr Trends Immunol 2015; 16:65–78.
• 16. Schulze J, Vogelgesang A, Dressel A. Catecholamines, steroids and immune alterations in ischemic stroke and other acute diseases. Aging Dis 2014; 5:327-39.
• 17. Agus HZ, Kahraman S, Arslan C, et al. Systemic immuneinflammation index predicts mortality in infective endocarditis. J Saudi Heart Assoc. 2020; doi:10.1016/ j. jsha.2019.11.001.
• 18. Audebert HJ, Rott MM, Eck T, et al. Systemic inflammatory response depends on initial stroke severity but is attenuated by successful thrombolysis. Stroke. 2004 Sep;35(9):2128-33. doi: 10.1161/01.STR.0000137607.61697.77. Epub 2004 Jul 22. PMID: 15272127.
• 19. Liu DD, Chu SF, Chen C, et al. Research progress in stroke-induced immunodepression syndrome (SIDS) and stroke-associated pneumonia (SAP). Neurochem Int. 2018 Mar; 114:42-54. doi: 10.1016/j.neuint.2018.01.002. Epub 2018 Jan 6. PMID: 29317279.
• 20. A. Liesz, E. Suri-Payer, C. Veltkamp, et al., Regulatory T cells are key cerebroprotective immunomodulators in acute experimental stroke, Nat. Med. 15 (2) (2009) 192–199.
• 21. Fowler AJ, Agha RA. Neutrophil/lymphocyte ratio is related to the severity of coronary artery disease and clinical outcome in patients undergoing angiography--the growing versatility of NLR. Atherosclerosis. 2013 May;228(1):44-5. doi: 10.1016/j.atherosclerosis.2013.02.008. Epub 2013 Feb 18. PMID: 23474126.
• 22. Wang L, Song Q, Wang C, et al. Neutrophil to lymphocyte ratio predicts poor outcomes after acute ischemic stroke: A cohort study and systematic review. J Neurol Sci. 2019 Nov 15; 406:116445. doi: 10.1016/j.jns.2019.116445. Epub 2019 Aug 31. PMID: 31521961.
• 23. Yang YL, Wu CH, Hsu PF, et al. Systemic immune-inflammation index (SII) predicted clinical outcome in patients with coronary artery disease. Eur J Clin Invest. 2020 May;50(5): e13230. doi: 10.1111/eci.13230. Epub 2020 May 11. PMID: 32291748.
• 24. Denorme F, Manne BK, Portier I, et al. Platelet necrosis mediates ischemic stroke outcome in mice. Blood. 2020 Feb 6;135(6):429-440. doi: 10.1182/blood.2019002124. PMID: 31800959; PMCID: PMC7005363.
• 25. Weng Y, Zeng T, Huang H, et al. Systemic Immune-Inflammation Index Predicts 3-Month Functional Outcome in Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis. Clin Interv Aging. 2021 May 20; 16:877-886. doi: 10.2147/CIA.S311047. PMID: 34040364; PMCID: PMC8143961.
• 26. Zhou YX, Li WC, Xia SH, et al. Predictive Value of the Systemic Immune Inflammation Index for Adverse Outcomes in Patients With Acute Ischemic Stroke. Front Neurol. 2022 Mar 18; 13:836595. doi: 10.3389/fneur.2022.836595. PMID: 35370926; PMCID: PMC8971364.
• 27. Hu J, Wang L, Fan K, et al. The Association Between Systemic Inflammatory Markers and Post-Stroke Depression: A Prospective Stroke Cohort. Clin Interv Aging. 2021 Jun 25; 16:1231-1239. doi: 10.2147/CIA.S314131. PMID: 34234423; PMCID: PMC8243596.
• 28. Yun S, Yi HJ, Lee DH, et al. Systemic Inflammation Response Index and Systemic Immune-inflammation Index for Predicting the Prognosis of Patients with Aneurysmal Subarachnoid Hemorrhage. J Stroke Cerebrovasc Dis. 2021 Aug;30(8):105861. doi: 10.1016/j.jstrokecerebrovasdis.2021.105861. Epub 2021 May 23. PMID: 34034125.
• 29. Yi HJ, Sung JH, Lee DH. Systemic Inflammation Response Index and Systemic Immune-Inflammation Index Are Associated with Clinical Outcomes in Patients Treated with Mechanical Thrombectomy for Large Artery Occlusion. World Neurosurg. 2021 Sep;153: e282-e289. doi: 10.1016/j.wneu.2021.06.113. Epub 2021 Jul 2. PMID: 34217857.