Abstract：
OBJECTIVE: The overwhelming inflammatory response plays a critical role in the secondary injury cascade of traumatic spinal cord injury (tSCI). The systemic immune inflammatory index (SII) and systemic inflammatory response index (SIRI) are two novel inflammatory biomarkers. The SII was calculated based on lymphocyte, neutrophil, and platelet counts, while the SIRI was calculated based on lymphocyte, neutrophil, and monocyte counts. Their prognostic value in patients with tSCI remains unclear.
METHODS: Patients with tSCI admitted within 24 h of trauma were retrospectively and consecutively enrolled. Peripheral blood samples were collected on admission. The primary outcome was American Spinal Injury Association Impairment Scale (AIS) grade conversion at discharge. Multivariable logistic regression analysis was performed to determine the relationship between SII and SIRI and AIS grade conversion. We performed receiver operating characteristic curve (ROC) analysis to assess the discriminative ability of SII, and SIRI in predicting AIS grade conversion.
RESULTS: Among 280 included patients, 77 (27.5%) had improved AIS grade conversion at discharge. After adjustment for confounders, SII was independently associated with AIS grade conversion (per SD, odds ratio [OR], 0.68; 95% confidence interval [CI] 0.47-0.98, p = 0.040), while the association between SIRI and AIS grade conversion was insignificant (per 1 SD, OR, 0.77; 95% CI 0.55-1.08, p = 0.130). The ROC analysis revealed that the SII had the best predictive value for AIS grade conversion (area under curve: 0.608, 95% CI 0.536-0.678).
CONCLUSIONS: Increased SII was independently associated with a decreased likelihood of improved AIS grade conversion.
METHODS: Patients with tSCI admitted within 24 h of trauma were retrospectively and consecutively enrolled. Peripheral blood samples were collected on admission. The primary outcome was American Spinal Injury Association Impairment Scale (AIS) grade conversion at discharge. Multivariable logistic regression analysis was performed to determine the relationship between SII and SIRI and AIS grade conversion. We performed receiver operating characteristic curve (ROC) analysis to assess the discriminative ability of SII, and SIRI in predicting AIS grade conversion.
RESULTS: Among 280 included patients, 77 (27.5%) had improved AIS grade conversion at discharge. After adjustment for confounders, SII was independently associated with AIS grade conversion (per SD, odds ratio [OR], 0.68; 95% confidence interval [CI] 0.47-0.98, p = 0.040), while the association between SIRI and AIS grade conversion was insignificant (per 1 SD, OR, 0.77; 95% CI 0.55-1.08, p = 0.130). The ROC analysis revealed that the SII had the best predictive value for AIS grade conversion (area under curve: 0.608, 95% CI 0.536-0.678).
CONCLUSIONS: Increased SII was independently associated with a decreased likelihood of improved AIS grade conversion.
摘要：
目的：压倒性的炎症反应在创伤性脊髓损伤（tSCI）的继发性损伤级联反应中起关键作用。全身免疫炎症指数(SII)和全身炎症反应指数(SIRI)是两种新型的炎症生物标志物。SII是根据淋巴细胞计算的，中性粒细胞,和血小板计数,虽然SIRI是根据淋巴细胞计算的，中性粒细胞,和单核细胞计数。它们在tSCI患者中的预后价值尚不清楚。
方法：回顾性并连续纳入创伤后24小时内收治的tSCI患者。入院时收集外周血样本。主要结果是出院时的美国脊髓损伤协会损害量表（AIS）等级转换。进行多变量逻辑回归分析以确定SII和SIRI与AIS等级转换之间的关系。我们进行了受试者工作特征曲线（ROC）分析，以评估SII的辨别能力，和SIRI预测AIS等级转换。
结果：在280名纳入的患者中，77(27.5%)在放电时AIS等级转化率提高。在对混杂因素进行调整后，SII与AIS等级转换独立相关(每SD，赔率比[OR]，0.68；95%置信区间[CI]0.47-0.98，p=0.040)，而SIRI和AIS等级转换之间的关联不显著(每1SD，OR,0.77；95%CI0.55-1.08，p=0.130）。ROC分析显示，SII对AIS等级转换具有最佳预测价值（曲线下面积：0.608，95％CI0.536-0.678）。
结论：SII增加与AIS等级转换改善的可能性降低独立相关。
方法：回顾性并连续纳入创伤后24小时内收治的tSCI患者。入院时收集外周血样本。主要结果是出院时的美国脊髓损伤协会损害量表（AIS）等级转换。进行多变量逻辑回归分析以确定SII和SIRI与AIS等级转换之间的关系。我们进行了受试者工作特征曲线（ROC）分析，以评估SII的辨别能力，和SIRI预测AIS等级转换。
结果：在280名纳入的患者中，77(27.5%)在放电时AIS等级转化率提高。在对混杂因素进行调整后，SII与AIS等级转换独立相关(每SD，赔率比[OR]，0.68；95%置信区间[CI]0.47-0.98，p=0.040)，而SIRI和AIS等级转换之间的关联不显著(每1SD，OR,0.77；95%CI0.55-1.08，p=0.130）。ROC分析显示，SII对AIS等级转换具有最佳预测价值（曲线下面积：0.608，95％CI0.536-0.678）。
结论：SII增加与AIS等级转换改善的可能性降低独立相关。
