Trajectories of systemic immune inflammation index and mortality risk in patients with moderate-to-severe traumatic brain injury: a retrospective cohort study
BackgroundSome studies have shown a strong link between the central nervous system and peripheral immune system, but the prognostic implications of dynamic peripheral immune-inflammatory responses in patients with traumatic brain injury (TBI) remain unclear. This study aimed to determine the dynamic...
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Frontiers Media S.A.
2025-02-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2024.1439318/full |
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| author | Zhiyong Tang Zhiyong Tang Canlin Liao Zerui Zhuang Zhennan Xu Mingfa Liu Haixiong Xu |
| author_facet | Zhiyong Tang Zhiyong Tang Canlin Liao Zerui Zhuang Zhennan Xu Mingfa Liu Haixiong Xu |
| author_sort | Zhiyong Tang |
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| description | BackgroundSome studies have shown a strong link between the central nervous system and peripheral immune system, but the prognostic implications of dynamic peripheral immune-inflammatory responses in patients with traumatic brain injury (TBI) remain unclear. This study aimed to determine the dynamic trajectory patterns of the Systemic Immune Inflammation Index (SII) in patients with TBI and assess its association with all-cause hospital mortality.MethodsThis retrospective cohort study utilized a large public database of patients with TBI sourced from the eICU Collaborative Research Database (eICU-CRD). Group-Based Trajectory Modeling (GBTM) was used to analyze daily SII trajectories during the initial 0–7 days of hospitalization. Logistic regression was employed to assess the relationship between different SII trajectory groups and hospital mortality. Receiver Operating Characteristic (ROC) curves were generated based on the logistic regression model.ResultsA total of 312 patients were included in this study, 52 of whom died during hospitalization. Using GBTM, three distinct SII trajectories were identified: Group 1 (low-level, rapid decline; 18.90%), Group 2 (moderate-level, slow decline; 60.20%), and Group 3 (sustained high-level; 20.80%). Compared to patients in Group 1, those in Groups 2 and 3 had a higher risk of all-cause hospital mortality (odds ratio [OR] 4.09; 95% confidence interval [CI] 1.21, 19.75) and (OR 5.84; 95% CI 1.52, 30.67), respectively. ROC analysis revealed an area under the curve (AUC) of 0.838, sensitivity: 75.0%, and specificity: 83.8% for mortality in this cohort.ConclusionThis study identified three distinct SII trajectories, suggesting that post-TBI SII trajectories are heterogeneous patterns associated with mortality. The sustained high-level SII trajectory may serve as a marker of disease deterioration, highlighting the need for targeted interventions. Describing the evolution of SII through GBTM and its correlation with clinical outcomes can enhance our understanding of the link between neuroinflammation and the peripheral immune system. |
| format | Article |
| id | doaj-art-b6d9e64377f54106b7938a3e243ce16d |
| institution | Kabale University |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj-art-b6d9e64377f54106b7938a3e243ce16d2025-02-12T05:14:53ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-02-011510.3389/fneur.2024.14393181439318Trajectories of systemic immune inflammation index and mortality risk in patients with moderate-to-severe traumatic brain injury: a retrospective cohort studyZhiyong Tang0Zhiyong Tang1Canlin Liao2Zerui Zhuang3Zhennan Xu4Mingfa Liu5Haixiong Xu6Department of Neurosurgery, Shantou Central Hospital, Shantou, Guangdong, ChinaDepartment of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaDepartment of Neurosurgery, Shantou Central Hospital, Shantou, Guangdong, ChinaDepartment of Neurosurgery, Shantou Central Hospital, Shantou, Guangdong, ChinaDepartment of Neurosurgery, Shantou Central Hospital, Shantou, Guangdong, ChinaDepartment of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaDepartment of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaBackgroundSome studies have shown a strong link between the central nervous system and peripheral immune system, but the prognostic implications of dynamic peripheral immune-inflammatory responses in patients with traumatic brain injury (TBI) remain unclear. This study aimed to determine the dynamic trajectory patterns of the Systemic Immune Inflammation Index (SII) in patients with TBI and assess its association with all-cause hospital mortality.MethodsThis retrospective cohort study utilized a large public database of patients with TBI sourced from the eICU Collaborative Research Database (eICU-CRD). Group-Based Trajectory Modeling (GBTM) was used to analyze daily SII trajectories during the initial 0–7 days of hospitalization. Logistic regression was employed to assess the relationship between different SII trajectory groups and hospital mortality. Receiver Operating Characteristic (ROC) curves were generated based on the logistic regression model.ResultsA total of 312 patients were included in this study, 52 of whom died during hospitalization. Using GBTM, three distinct SII trajectories were identified: Group 1 (low-level, rapid decline; 18.90%), Group 2 (moderate-level, slow decline; 60.20%), and Group 3 (sustained high-level; 20.80%). Compared to patients in Group 1, those in Groups 2 and 3 had a higher risk of all-cause hospital mortality (odds ratio [OR] 4.09; 95% confidence interval [CI] 1.21, 19.75) and (OR 5.84; 95% CI 1.52, 30.67), respectively. ROC analysis revealed an area under the curve (AUC) of 0.838, sensitivity: 75.0%, and specificity: 83.8% for mortality in this cohort.ConclusionThis study identified three distinct SII trajectories, suggesting that post-TBI SII trajectories are heterogeneous patterns associated with mortality. The sustained high-level SII trajectory may serve as a marker of disease deterioration, highlighting the need for targeted interventions. Describing the evolution of SII through GBTM and its correlation with clinical outcomes can enhance our understanding of the link between neuroinflammation and the peripheral immune system.https://www.frontiersin.org/articles/10.3389/fneur.2024.1439318/fulltraumatic brain injury (TBI)neuroinflammationgroup-based trajectory modeling (GBTM)inflammatory biomarkerssystemic immune inflammation index (SII)all-cause hospital mortality |
| spellingShingle | Zhiyong Tang Zhiyong Tang Canlin Liao Zerui Zhuang Zhennan Xu Mingfa Liu Haixiong Xu Trajectories of systemic immune inflammation index and mortality risk in patients with moderate-to-severe traumatic brain injury: a retrospective cohort study Frontiers in Neurology traumatic brain injury (TBI) neuroinflammation group-based trajectory modeling (GBTM) inflammatory biomarkers systemic immune inflammation index (SII) all-cause hospital mortality |
| title | Trajectories of systemic immune inflammation index and mortality risk in patients with moderate-to-severe traumatic brain injury: a retrospective cohort study |
| title_full | Trajectories of systemic immune inflammation index and mortality risk in patients with moderate-to-severe traumatic brain injury: a retrospective cohort study |
| title_fullStr | Trajectories of systemic immune inflammation index and mortality risk in patients with moderate-to-severe traumatic brain injury: a retrospective cohort study |
| title_full_unstemmed | Trajectories of systemic immune inflammation index and mortality risk in patients with moderate-to-severe traumatic brain injury: a retrospective cohort study |
| title_short | Trajectories of systemic immune inflammation index and mortality risk in patients with moderate-to-severe traumatic brain injury: a retrospective cohort study |
| title_sort | trajectories of systemic immune inflammation index and mortality risk in patients with moderate to severe traumatic brain injury a retrospective cohort study |
| topic | traumatic brain injury (TBI) neuroinflammation group-based trajectory modeling (GBTM) inflammatory biomarkers systemic immune inflammation index (SII) all-cause hospital mortality |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2024.1439318/full |
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