Prognostic Significance of SIRI and SII in Posttraumatic Hydrocephalus Following Traumatic Brain Injury

Traumatic brain injury (TBI) is a leading cause of global mortality and morbidity. Posttraumatic hydrocephalus (PTH) often occurs in patients recovering from TBI surgery, but its diagnosis is challenging due to limited clinical features and accurate scales.

This study aims to identify the risk factors associated with PTH, particularly the inflammatory estimates, systemic inflammatory response index (SIRI), and systemic immune inflammation index (SII) in PTH and its association with outcome following treatment for TBI.

This retrospective study included TBI surgery patients recruited during intensive care unit (ICU) recovery and followed for 2 years for PTH occurrence. Baseline demographic, blood, and biochemical data were collected at admission, and patients were monitored from discharge to PTH onset or death. Risk factors for PTH and outcome associations were analyzed using univariate and multivariable logistic regression models.

A total of 12.42% ( n  = 55) from a cohort of 443 patients developed PTH. The univariate regression showed factors like decompressive craniectomy, postoperative meningitis, Glasgow Coma Scale (GCS), hospital stay, SIRI, and SII to be associated with PTH. SIRI and SII show high statistical significance ( p  < 0.001). The best-fit multivariate model determined that preadmission GCS ( p  < 0.003), length of ICU stay ( p  < 0.003), and GCS at discharge ( p  < 0.025) and SII ( p  < 0.001) were significantly associated with PTH. Elevated SIRI and SII levels were strongly associated with PTH occurrence. Determining the incidence of risk factors, in a larger cohort may establish the association of SIRI and SII as potential inflammatory surrogate markers in the risk of PTH development that can improve earlier detection and effective treatment for PTH management.