• Huajie Xu, Wei Wu, Qi Zhu, Jie Wang, Pengfei Ding, Zong Zhuang, Wei Li, Yongyue Gao, and Chunhua Hang.
• Department of Neurosurgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China; Neurosurgical Institute of Nanjing University, Nanjing, Jiangsu, China.
• World Neurosurg. 2024 Mar 1; 183: e22e27e22-e27.

ObjectiveSystemic inflammation following traumatic brain injury (TBI) has been extensively studied over the past decades, as it contributes significantly to the pathophysiological injury mechanisms and subsequent poor outcomes. Systemic immune-inflammation (SII) index is a novel biomarker of systemic inflammatory response. However, its predictive value regarding TBI prognosis in clinical practice remains insufficiently investigated.MethodsA total of 102 TBI patients admitted to Nanjing Drum Tower Hospital from July 2019 to February 2022 were enrolled. We employed various statistical analyses to evaluate the correlation between inflammatory indicators upon admission and patient prognosis, compared the predictive accuracy of these indicators, and generated receiver operating curve analysis to test their prognostic performance.ResultsThe SII index, platelet count, absolute lymphocyte count, and neutrophil/lymphocyte ratio (NLR) were capable of distinguishing TBI prognosis according to univariate logistic regression models (P < 0.05). Multivariate logistic regression models revealed that increased SII index, platelet count, and NLR upon admission were independent predictors of poor TBI prognosis (P < 0.05). Receiver operating curve analysis further demonstrated that the SII index (area under the curve = 0.845, 95% confidence interval 0.769-0.921, P = 0.000) exhibited higher predictive ability than the NLR (area under the curve = 0.694, 95% confidence interval 0.591-0.796, P = 0.001).ConclusionsOur findings suggested that increased SII index during the early stages of TBI was an independent risk factor for poor prognosis with satisfactory predictive value. The SII index provides a reliable, convenient, and cost-effective prognostic model to evaluate systemic inflammation after TBI and identify patients at risk of poor outcomes, thereby offering valuable guidance for clinical practice.Copyright © 2023 Elsevier Inc. All rights reserved.

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