Predictive Value of the Modified Comprehensive Immunoinflammatory Indices for Hemorrhagic Transformation in Ischemic...

Ischemic stroke is closely related to inflammation and immune balance. The purpose of this study was to investigate the relationship of modified comprehensive immunoinflammatory indices (modified pan-immune-inflammation-value (mPIV), modified systemic immune-inflammatory index (mSII), modified systemic inflammatory response index (mSIRI)) and hemorrhagic transformation (HT) of ischemic stroke.

894 ischemic stroke patients treated in Meizhou People's Hospital from January 2019 to May 2024 were retrospectively analyzed. Clinical characteristics were collected, and mPIV, mSII, and mSIRI were calculated. The optimal cutoff values of mPIV, mSII, and mSIRI were analyzed by receiver operating characteristic (ROC) curve analysis. The relationship between mPIV, mSII, mSIRI and HT of ischemic stroke was analyzed.

There were 685 (76.6%) patients without HT and 209 (23.4%) with HT. The cases with HT had higher mPIV (1337.71 (698.79, 2511.19) vs 992.37 (599.30, 1884.53), p=0.001), mSII (3418.31 (1895.87, 7112.89) vs 2574.81 (1630.46, 4006.18), p<0.001), and mSIRI level (963.60 (517.86, 1947.87) vs 698.75 (446.99, 1100.62), p<0.001) than those without HT. In ROC analysis, the cutoff value of mPIV was 1302.4 (sensitivity 50.7%, specificity 64.7%, area under the ROC curve (AUC): 0.575), mSII cutoff value was 3186.5 (sensitivity 54.5%, specificity 63.8%, AUC: 0.605), and mSIRI cutoff value was 996.5 (sensitivity 49.8%, specificity 70.2%, AUC: 0.610). Logistic regression analysis showed that high mPIV (odds ratio (OR): 1.901, 95% confidence interval (CI): 1.381-2.617, p<0.001), high mSII (OR: 2.081, 95% CI: 1.517-2.854, p<0.001), and high mSIRI (OR: 2.290, 95% CI: 1.664-3.151, p<0.001) were significantly associated with HT.

High levels of mPIV, mSII, and mSIRI may be associated with hemorrhagic transformationin patients with ischemic stroke who received intravenous thrombolysis treatment.