Systemic Immune-Inflammatory Markers for Predicting Infarct Volume and Mortality in Patients with Acute Ischemic...

Objectives: In patients presenting to the emergency department with acute ischemic stroke (AIS), there is a growing need for practical and rapid biomarkers that can effectively predict prognosis and infarct volume, complementing neurological examination and imaging methods. Methods: This study retrospectively evaluates patients diagnosed with AIS at the emergency department of Bilecik Training and Research Hospital between 1 March 2022, and 30 September 2023. Patients who were transferred for reperfusion therapy were excluded, as thrombolysis and mechanical thrombectomy were not available at our institution during the study period. The systemic immune-inflammation index (SII) and the systemic inflammation response index (SIRI) scores were calculated based on patients' laboratory values. Additionally, infarct volumes were independently assessed by two experienced radiologists and calculated by multiplying the hyperintense areas on diffusion-weighted magnetic resonance imaging by slice thickness. Results: Of the 349 patients diagnosed with AIS during this study period, 257 who met the inclusion criteria were analyzed. The median age was 76 years (IQR: 66-83), and 130 (51%) patients were female. Lacunar infarction was present in 109 patients (42.4%), while 148 (57.6%) had non-lacunar infarction. The all-cause mortality rates at 1 month, 1 year, and 2 years were 7.8%, 21.4%, and 29.6%, respectively. SII and SIRI scores were significantly higher in deceased patients compared to survivors across all time points for mortality. Conclusions: The findings of this study suggest that SII and SIRI values, derived from complete blood count parameters, may contribute to the early identification and management of high-risk AIS patients.