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A High Immediate Postoperative Systemic Immune-inflammation Index Is Associated With Postoperative Symptomatic
Na Young Kim1, Kyung Won Shin1, Woo-Young Jo1
1Department of Anesthesiology and Pain Medicine.
Background:
Inflammation plays a role in the pathogenesis of cerebral infarction. Postoperative symptomatic cerebral infarction (SCI) is a complication after revascularization surgery in patients with moyamoya disease (MMD). We investigated the association between the systemic-immune-inflammation index (SII) and postoperative SCI during hospital stay in such patients.
Methods:
Perioperative data were retrospectively obtained from 681 MMD patients who underwent revascularization surgery. SII cutoff values were identified as those where the sum of sensitivity and specificity associated with SCI were highest. Patients were divided into 4 subgroups according to the preoperative and immediate postoperative cutoff SII: HH (preoperative and postoperative SII high, n=22), LH (low preoperative and high postoperative SII, n=68), HL (high preoperative and low postoperative SII, n=125), and LL (preoperative and postoperative SII low, n=466).
Results:
Postoperative SCI occurred in 54 (7.6%) patients. The cutoff values for preoperative and immediate postoperative SII were 641.3 and 1925.4, respectively. Postoperative SCI during hospital stay was more frequent in the high postoperative SII group than in the low postoperative SII group (25.6% vs. 4.9%; P <0.001). Multivariate analysis revealed that a high immediate postoperative SII was a predictor of postoperative SCI (odds ratio, 11.61; 95% CI: 5.20-26.00; P <0.001). Postoperative SCI was lower in group LL than in group LH (3.6% vs. 23.5%, P <0.008) and was lower in group HL than in groups HH and LH (9.6% vs. 31.8% and 23.5%, both P <0.05).
Conclusions:
A high immediate postoperative SII was associated with postoperative SCI during hospital stay in MMD patients who underwent revascularization surgery.
Insights
A high systemic-immune-inflammation index (SII) after surgery predicts symptomatic cerebral infarction (SCI) in moyamoya disease (MMD) patients. Monitoring postoperative SII can help identify patients at risk for SCI following revascularization surgery.
Area of Science:
- Neurology
- Immunology
- Surgical Complications
Background:
- Inflammation is implicated in cerebral infarction.
- Postoperative symptomatic cerebral infarction (SCI) is a complication in moyamoya disease (MMD) patients undergoing revascularization surgery.
Purpose of the Study:
- To investigate the association between the systemic-immune-inflammation index (SII) and postoperative SCI in MMD patients.
Main Methods:
- Retrospective analysis of perioperative data from 681 MMD patients.
- Identification of SII cutoff values for predicting SCI.
- Classification of patients into four subgroups based on preoperative and postoperative SII levels.
Main Results:
- Postoperative SCI occurred in 7.6% of patients.
- A high immediate postoperative SII was a significant predictor of postoperative SCI (OR, 11.61; P <0.001).
- The incidence of SCI was higher in patients with high postoperative SII compared to those with low postoperative SII (25.6% vs. 4.9%; P <0.001).
Conclusions:
- A high immediate postoperative SII is associated with an increased risk of postoperative SCI during hospital stay in MMD patients.
- Postoperative SII monitoring may aid in identifying patients at risk for SCI after revascularization surgery.
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