Impact of systemic immune inflammation index on the prognosis of intravenous thrombolysis in patients with atrial fibrillation and cerebral infarction

CHEN Hui; YANG Long; QI Chun-mei

doi:10.3969/j.issn.1672-5301.2025.05.013

Abstract：Objective To investigate the impact of the systemic immune-inflammation index(SII)on the prognosis of intravenous thrombolysis in patients with atrial fibrillation and cerebral infarction.Methods The clinical data of 230 patients with cerebral infarction complicated with atrial fibrillation who underwent intravenous thrombolysis were retrospectively analyzed from February 2022 to February 2024 in the Affiliated Hospital of Xuzhou Medical University.Blood routine and other baseline clinical data were collected at admission.The SII,platelet to lymphocyte ratio(PLR)and neutrophil to lymphocyte ratio(NLR)were calculated based on peripheral platelet,neutrophil and lymphocyte counts.The 90-day clinical prognosis of the patients was evaluated using the modified Rankin Scale(mRS),with mRS＞2 scores as the poor prognosis group and mRS≤2 scores as the good prognosis group.Multivariate Logistic regression was used to analyze the relationship between various inflammatory indexes and 90-day clinical prognosis,and to analyze the predictive value of SII,PLR and NLR for 90-day poor prognosis of the patients.Results A total of 230 patients were included,of which 85(37.0％)had poor prognosis after 90 days of onset.Compared with the good prognosis group,the leukocyte count,neutrophil percentage,C-reactive protein,SII,PLR and NLR in the poor prognosis group were significantly increased,and the differences were statistically significant(P＜0.05).Multivariate Logistic regression analysis showed that after adjusting for confounding factors,the SII[odds ratio(OR)was 1.368,95％confidence interval(CI)was 1.206-1.379;P＜0.001],PLR(OR=1.392,95％CI 1.239-1.320;P＜0.001)and NLR(OR=1.246,95％CI 1.293-6.769;P＜0.001)were associated with poor prognosis at 90 days of onset.ROC curve construction found that the areas under the curve of SII,PLR and NLR to predict poor prognosis of thrombolysis patients at 90 days of onset were 0.848(95％CI 0.725-0.930),0.803(95％CI 0.538-0.798)and 0.771(95％CI 0.582～0.832)respectively,with statistically significances(P＜0.05).Conclusion SII is associated with the prognosis of intravenous thrombolysis in pations with atrial fibrillation and cerebral infarction and high SII level at admission is an independent risk factor for poor short-term prognosis in these patients.