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Updated: Jul 1, 2026
Systems Analysis of the Neuroinflammatory and Hemodynamic Response to Traumatic Brain Injury
Published on: May 27, 2022
The Association of Systemic Immune Inflammation Index (SII) and Platelet-to-Lymphocyte Ratio (PLR) on Coagulopathy
Jiali Chen1,2, Jiahui Fu1,2, Jiazhuo Liu1,2
1Department of Treatment Center For Traumatic Injuries, The Third Affiliated Hospital, Southern Medical University, Guangzhou, Guangdong, People's Republic of China.
Objective:
We aimed to investigate the associations between inflammatory immune indicators, specifically systemic immune inflammation index (SII), platelet-to-lymphocyte ratio (PLR) and the coagulopathy and prognosis of traumatic brain injury (TBI) patients in ICU.
Methods:
One hundred sixty-one TBI patients were grouped into four groups. The outcomes included TBI-related coagulopathy and prognosis at six months after discharge. The association between SII, PLR and coagulopathy, and prognosis in TBI patients was elucidated by applying trend analysis, sensibility analysis, spearman correlation, restricted cubic splines and so on.
Results:
Sixty-four (39.75%) of 161 TBI patients were diagnosed with coagulopathy. In the unadjusted model, TBI patients in the lowest quarter of SII (≤966.60) and PLR levels (≤97.99) had a higher risk of coagulopathy than those in the highest quarter of SII (≥3096.16) [OR 0.169 (95% CI 0.052-0.547)] and PLR (≥255.39) [OR 0.098 (95% CI 0.028-0.340)]. After adjusting for covariates, the significant negative associations of results remained consistent in the sensitivity analyses. Restricted cubic splines revealed that an almost linear relationship between SII, PLR and coagulopathy risk and poor prognosis (P for all nonlinearities > 0.05). Finally, receiver operating characteristic (ROC) curves indicated that the SII and PLR had certain diagnostic and predictive values for TBI-related coagulopathy [AUC(SII) = 0.666 (95% CI 0.566-0.766), AUC(PLR) = 0.752 (95% CI 0.662-0.842)] and prognosis [AUC(SII) = 0.657 (95% CI 0.548-0.766), AUC(PLR) = 0.700 (95% CI 0.596-0.805)]. The stratification of isolated TBI and TBI with multi-trauma does not affect SII and PLR in predicting TBI-related coagulopathy and poor prognosis in the subgroup analysis (P > 0.05).
Conclusion:
This study demonstrated that the SII and PLR had a significant correlation with coagulopathy risk and prognosis at 6 months after discharge. SII and PLR were predictive of coagulopathy and poor prognosis, specifically PLR value. It suggests that the SII and PLR might be promising biomarkers for predicting TBI-related coagulopathy and prognosis.
Trial Registration:
The study was registered in the ethics committee of the Third Affiliated Hospital of Southern Medical University (2024-ER-005).
