Tohoku J. Exp. Med., 2025 February, 265(2)

Prognostic Value of Systemic Immune-Inflammation Index and Systemic Inflammatory Response Index on Functional Status and Mortality in Patients with Critical Acute Ischemic Stroke

Kadir Arslan¹ and Ayca Sultan Sahin¹

¹University of Health Sciences, Kanuni Sultan Süleyman Training and Research Hospital, Department of Anesthesiology and Reanimation, Istanbul, Turkey

Neuroinflammation plays an essential role in the pathogenesis of acute ischemic stroke (AIS). This study aims to investigate the predictive value of the systemic immune-inflammation index (SII) and systemic inflammatory response index (SIRI) on mortality and functional limitation in patients with critical AIS. Patients with critical AIS in a tertiary hospital’s intensive care unit (ICU) between June 2020 and 2022 were retrospectively examined. Patients were classified according to their 28-day mortality (survivor and non-survivor group) and functional status (poor and good functional outcomes). The performances of SII and SIRI in predicting mortality and functional outcomes were compared. A total of 198 patients were included in the study. The median age of the entire population was 70 (56-86) years, and 52% (n = 103) were male. Coronary vascular disease/heart failure was found to be significantly higher in the mortality group (p = 0.025). While SII was found to be significantly higher in the mortality group (1,180 vs. 811, p = 0.038), SIRI did not show a significant difference (1.82 vs. 1.70, p = 0.257). SII and SIRI were significantly higher in the poor functional outcome group (p < 0.001 and p = 0.015). In the ROC analysis of the functional status prediction performances of SII and SIRI, the cut-off value of SII was ≥ 1,146, the area under the curve (AUC) = 0.645 (0.568-0.722), the cut-off value of SIRI was ≤ 2.54, AUC = 0.600 (0.520-0.680) was detected. SII helps predict 28-day mortality in patients with critical AIS. Both SII and SIRI can predict functional status at discharge.

Key words —— acute ischemic stroke; functional outcome; prognosis; systemic immune-inflammation index; system inflammation response index

© 2025 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2025 February, 265(2), 91-97.

Correspondence: Kadir Arslan, University of Health Sciences, Kanuni Sultan Süleyman Training and Research Hospital, Department of Anesthesiology and Reanimation, Istanbul 34303, Turkey.

e-mail:kadir.arslan@sbu.edu.tr

Correspondence: Ayca Sultan Sahin, University of Health Sciences, Kanuni Sultan Süleyman Training and Research Hospital, Department of Anesthesiology and Reanimation, Istanbul 34303, Turkey.

e-mail:aycasultan@gmail.com