Research Paper Volume 14, Issue 16 pp 6567—6578

Correlation of the systemic immune-inflammation index with short- and long-term prognosis after acute ischemic stroke

Nan Wang1,2, , Yingying Yang2,3, , Baoshan Qiu2,3, , Ying Gao2,3, , Anxin Wang2,3, , Qin Xu2,3, , Xia Meng2,3, , Yuming Xu1, , Bo Song1, , Yongjun Wang2,3, , Yilong Wang2,3, ,

  • 1 Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Henan, China
  • 2 Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
  • 3 China National Clinical Research Centre for Neurological Diseases, Beijing, China

Received: October 25, 2021       Accepted: June 1, 2022       Published: August 19, 2022
How to Cite

Copyright: © 2022 Wang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Immune and inflammatory responses after stroke are important pathophysiological processes. This study explored the relationship between the systemic immune-inflammation index (SII) and stroke prognosis. Patients from the China National Stroke Registry III were investigated. SII was defined as neutrophils × platelets/lymphocytes, and the patients were divided into four groups according to quartiles based on SII values. The primary outcome was poor functional outcome, assessed by the modified Rankin Scale (mRS), defined as an mRS score of ≥3. The secondary outcome was the incidence of all-cause death and recurrent stroke. Data were analyzed using either the logistic regression or Cox regression models. As the SII quartile increased, the percentage of patients with poor functional outcomes increased: 178 (7.8%), 223 (9.8%), 292 (12.8%), and 417 (18.3%) (P < 0.0001) at the 90-day follow-up and 172 (7.6%), 203 (8.9%), 266 (11.7%), and 386 (17.0%) (P < 0.0001) at the 1-year follow-up. Compared to patients in the quartile (Q)1 group, those in the Q4 group had a higher risk for adverse events, especially all-cause death at the 90-day follow-up (adjusted hazard ratio [HR], 2.409; 95% confidence interval [CI], 1.273–4.559, P = 0.0069) and at the 1-year follow-up visits (adjusted HR, 2.209; 95% CI, 1.474–3.311, P = 0.0001). The SII was closely related to the short- and long-term prognosis of patients with acute ischemic stroke, and patients with higher SIIs were more likely to have poor outcomes.


CI: confidence interval; CNSR-III: China National Stroke Registry III; HR: hazard ratio; IQR: interquartile range; mRS: modified Rankin Scale; NIHSS: National Institutes of Health Stroke Scale; OR: odds ratio; Q: quartile; SII: systemic immune-inflammation index.