Delayed cerebral ischemia (DCI) is a factor contributing to poor outcome of aneurysmal subarachnoid hemorrhage (aSAH). Serial inflammatory response is known to affect the occurrence of DCI. The aim of this study was to evaluate associations of dynamic changes of various inflammatory markers with occurrence of DCI after aSAH. A total of 279 patients with interventional treatment for aSAH were enrolled, and dichotomized according to the occurrence of DCI. Various inflammatory markers, including systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and their dynamic changes were analyzed at four different time points. Receiver operating characteristic (ROC) curve analysis with area under the curve (AUC) and univariate, multivariate Cox regression analyses with hazard ratio (HR) and 95% confidence interval (CI) were performed to identify predictors for DCI. Differences of SII and SIRI values between DCI (+) and DCI (-) group were significantly higher at 5-7 days than at other time points (P < 0.001 and P < 0.001, respectively). SII and SIRI had higher predicting values for DCI occurrence than other inflammatory markers (AUC: 0.862, 95% CI: 0.786-0.928; P < 0.001 and AUC: 0.851, 95% CI: 0.769–0.913; P < 0.001, respectively). SII at 5-7 days (HR: 1.74, 95% CI: 1.38–3.22, P = 0.020) and SIRI at 5-7 days (HR: 1.62, 95% CI: 1.28–2.84, P = 0.035) were associated with occurrence of DCI. Dynamic changes of SII and SII might be predictors of DCI occurrence in patients with aSAH.

中文翻译：

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全身炎症反应指数和全身免疫炎症指数的动态变化与动脉瘤性蛛网膜下腔出血后迟发性脑缺血的相关性

迟发性脑缺血（DCI）是导致动脉瘤性蛛网膜下腔出血（aSAH）预后不良的一个因素。已知一系列炎症反应会影响 DCI 的发生。本研究的目的是评估aSAH后各种炎症标志物的动态变化与DCI发生的关系。共有279例接受aSAH介入治疗的患者入组，并根据DCI的发生情况进行二分。分析4个不同时间点的各种炎症标志物，包括全身免疫炎症指数（SII）、全身炎症反应指数（SIRI）及其动态变化。采用曲线下面积 (AUC) 进行受试者工作特征 (ROC) 曲线分析，以及采用风险比 (HR) 和 95% 置信区间 (CI) 的单变量、多变量 Cox 回归分析，以确定 DCI 的预测因素。DCI（+）组和DCI（-）组SII和SIRI值的差异在5-7天显着高于其他时间点（分别为P < 0.001和P < 0.001）。SII和SIRI对DCI发生的预测值高于其他炎症标志物（AUC：0.862，95% CI：0.786-0.928；P < 0.001；AUC：0.851，95% CI：0.769-0.913；P < 0.001）。5-7 天的 SII（HR：1.74，95% CI：1.38–3.22，P = 0.020）和 5-7 天的 SIRI（HR：1.62，95% CI：1.28–2.84，P = 0.035）与DCI 的发生。SII和SII的动态变化可能是aSAH患者DCI发生的预测因子。