ArticlePloS one2025
Systemic immune-inflammation index is associated with clinical outcome of acute ischemic stroke patients after intravenous thrombolysis treatment.
Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 10 papers, 1 of them a synthesis that pooled it.
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10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Comparison of the predictive performance of systemic immune-inflammation index and neutrophil-to-lymphocyte ratio for three-month poor functional outcome in ischemic stroke: a systematic review and meta-analysis.Annals of medicine · 2026Pooled it
- Systemic immune-inflammation index, stress hyperglycemia ratio and triglyceride-glucose index in acute ischemic stroke: an integrated inflammation-stress-metabolism perspective.Frontiers in neurology · 2026Review
- Predictive value of blood composite biomarkers for hemorrhagic transformation following mechanical thrombectomy in acute anterior circulation large vessel occlusion stroke patients.Frontiers in neuroscience · 2026Article
- Serial immune-inflammatory recovery trajectories after acute ischemic stroke: associations with early neurological deterioration and 90-day functional outcome in a retrospective cohort.Frontiers in neurology · 2026Article
- Complete blood count-derived inflammatory markers in canine cerebrovascular accidents: diagnostic utility and prognostic implications.Frontiers in veterinary science · 2026Article
- Inflammatory Response Indices in Patients with Acute Ischemic Stroke Treated with and Without Reperfusion Therapy.Journal of clinical medicine · 2025Article
- Tracing Inflammation in Ischemic Stroke: Biomarkers and Clinical Insight.International journal of molecular sciences · 2025Review
- Prognostic significance of the C-reactive protein-albumin-lymphocyte index and the pan-immune-inflammation value in ischemic and hemorrhagic stroke: a comparative analysis of subtypes.Frontiers in neurology · 2025Article
- Article
- Systemic inflammation-based hematological indices and 90-day functional outcomes after intravenous thrombolysis in acute ischemic stroke: a systematic review.Frontiers in neurology · 2025Review
Corrections and comments
- Erratum issued
Authors and funding
13 authors.
Funding
Abstract
introductionThe systemic immune-inflammation index (SII) has been proven to predict the outcome in cancerous and non-cancerous diseases. We aimed to investigate the relationship between SII and other inflammatory markers and the prognosis in patients receiving intravenous thrombolysis (IVT).
methodsAcute ischemic stroke patients treated with IVT were collected retrospectively. SII, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were constructed based on admission blood testing. Favorable outcome was defined as modified Rankin Scale of less than or equal to 2 at 90 days. In addition to outcome, cerebral edema was analyzed. The severity of brain edema was graded into three levels according to Thrombolysis in Stroke-Monitoring Study. Malignant cerebral edema (MCE) was defined as brain edema with midline shift.
results278 patients were included. 140 (50.4%) achieved favorable outcome, 35 (12.6%) developed MCE. In patients with favorable outcomes, the levels of SII, NLR and PLR were lower compared to those with unfavorable outcomes [422.33 (258.69-624.68) vs 1269.83 (750.82-2497.22), p < 0.001; 2.73 (1.68-4.40) vs 4.76 (2.59-7.72), p < 0.001; 92.98 (62.35-126.24) vs 115.64 (85.51-179.04), p < 0.001]. The area under the Receiver Operating Characteristic curve was 0.698 for SII (95% CI = 0.637-0.760, p < 0.001), 0.694 for NLR (95% CI = 0.632-0.756, p < 0.001), 0.643 for PLR (95% CI = 0.579-0.707, p < 0.001). The optimal cut-off values were 652.73 for SII (sensitivity 0.572, specificity 0.786), 3.57 for NLR (sensitivity 0.659, specificity 0.693), 127.01 for PLR (sensitivity 0.457, specificity 0.757).
conclusionsAn early increase in SII levels was related to 3 months of unfavorable outcomes in AIS patients after IVT. However, it is not associated with malignant edema.
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