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Blood inflammatory biomarkers predict in-hospital pneumonia after endovascular treatment of aneurysm in patients with aneurysmal subarachoid hemorrhage

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Abstract

The systemic inflammatory response index (SIRI) is a well-known marker of systemic inflammation reflecting the body’s inflammatory/immune state. The study aimed to evaluate the relationship between the SIRI on admission and aneurysmal subarachnoid hemorrhage (aSAH)-associated pneumonia and compare with other currently used bio-markers. We reviewed 562 successive patients with aneurysmal SAH who underwent endovascular treatment between January 2019 and September 2021. ASAH-associated pneumonia was diagnosed using the modified Centers for Disease Control and Prevention criteria. The SIRI on admission was calculated as monocyte count × neutrophil count / lymphocyte count. Multiple logistic regression models were used for data analysis. A total of 158 (28.11%) patients developed aSAH-associated pneumonia. Using the Multiple logistic regression analysis, a notable dose–response association was found between the elevated SIRI (fourth quartile) and aSAH-associated pneumonia (adjusted odds ratio = 6.759; 95% confidence interval [CI], 3.280–13.930; p < 0.001 [p for trend < 0.001]). The SIRI (0.701, 95% CI: 0.653–0.749) presented a higher area under the curve (AUC) than systemic immune- inflammation index (SII) (0.669, 95% CI: 0.620–0.718) (p = 0.089); neutrophil-to-lymphocyte ratio (NLR) (0.665, 95% CI: 0.616–0.714) (p = 0.035) and platelet-lymphocyte ratio (PLR) (0.587, 95% CI: 0.534–0.641) (p < 0.001). A higher SIRI on admission was associated with aSAH-associated pneumonia, which may guide further clinical trials of prophylactic antibiotic therapy.

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Data availability

We enrolled patients at three centers (Beijing Tiantan Hospital, Capital Medical University; Beijing Tongren Hospital, Capital Medical University; The Third Xiangya Hospital, Central South University) from January 2019 to September 2021. If necessary, we can provide the data set to the editor.

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Acknowledgements

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Funding

This study was supported by Natural Science Foundation of China (81771233, 82171290), Research and Promotion Program of Appropriate Techniques for Intervention of Chinese High-risk Stroke People(GN-2020R0007), BTH Coordinated Development-Beijing Science and Technology Planning Project(Z181100009618035), Beijing Municipal Administration of Hospitals’ Ascent Plan (DFL20190501), and Beijing Natural Science Foundation (19L2013; 22G10396).

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  1. Yongkai Qin and Lang Liu contributed equally to this work.

Authors and Affiliations

  1. Department of Neurosurgery, The Third Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China

    Yongkai Qin, Lang Liu, Mingyang Han, Siyuan Dong, Songfeng Zhao & Shenkun Tang

  2. Department of Neurosurgery, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China

    Shangfeng Zhao, Wei Wang & Baorui Zhang

  3. Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China

    Yan Miao

  4. Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China

    Zhongxue Wu & Aihua Liu

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  1. Yongkai Qin
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Contributions

Yongkai Qin , Aihua Liu , Baorui Zhang and Zhongxue Wu conceived the study concept. Yongkai Qin ,Lang Liu, Shangfeng Zhao and Wei Wang participated in the design of the study. Yongkai Qin, Lang Liu, Mingyang Han, Siyuan Dong, Songfeng Zhao, Yan Miao, Shenkun Tang collected data. Siyuan Dong, Yongkai Qin, Mingyang Han, Shangfeng Zhao and Wei Wang analyzed and interpreted the data. Yongkai Qin, Lang Liu ,Baorui Zhang, and Aihua Liu drafted and edited the manuscript. Aihua Liu, Baorui Zhang, Yongkai Qin, and Lang Liu had full access to all the data in the study and takes responsibility for the data and the accuracy of the data analysis. All the authors approved the final manuscript.

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Correspondence to Baorui Zhang or Aihua Liu.

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Informed consent was obtained for all participants. This study was approved by the centers review board (Beijing Tiantan Hospital, Capital Medical University; Beijing Tongren Hospital, Capital Medical University; The Third Xiangya Hospital, Central South University) and was in accordance with the principles of the Declaration of Helsinki.

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Qin, Y., Liu, L., Zhao, S. et al. Blood inflammatory biomarkers predict in-hospital pneumonia after endovascular treatment of aneurysm in patients with aneurysmal subarachoid hemorrhage. Neurosurg Rev 46, 171 (2023). https://doi.org/10.1007/s10143-023-02082-5

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