Use of A Systemic Inflammatory Response Index to Predict Non-Traumatic Non-Aneurysmal Subarachnoid Hemorrhage Patient Outcomes.

BACKGROUND: Patients who suffer from non-traumatic non-aneurysmal subarachnoid hemorrhage (naSAH) episodes still face a risk of clinical complications and poor outcome. As the systemic inflammatory response index (SIRI) has recently been shown to offer value as a tool capable of predicting aneurysmal SAH (aSAH) patient outcomes, this study was designed to gauge SIRI prognostic utility in naSAH patients.

METHODS: Clinical findings and outcome data for 111 naSAH patients were analyzed, with patients being separated into high- and low-SIRI groups. The modified Rankin scale (mRS) was used to compare 3-month outcomes in these patients, with mRS scores of 0-1 and 2-6 respectively corresponding to functional outcomes that were favorable and unfavorable. The association between SIRI levels and clinical outcomes was assessed using receiver operating characteristic (ROC) curves, area under the curve (AUC) values, and logistic regression approaches.

RESULTS: Of the 111 patients included in this study, 38 (34.2%) exhibited poor outcomes. An optimal SIRI cut-off of 6.478 × 109 /L was established for patient stratification. Multivariate logistic regression analyses revealed that SIRI was independently associated with the risk of poor patient outcomes (OR=11.35, 95% CI: 2.2-58.39, P = 0.004). The AUC value when using SIRI values to predict unfavorable patient outcomes was 0.806 (95% CI: 0.734-0.905, P < 0.001). Relative to other clinical metrics including white blood cell (WBC), absolute neutrophil count (ANC), absolute monocyte count (AMC), and absolute lymphocyte count (ALC), SIRI values yielded a relatively higher AUC value when analyzed via DeLong's test (p = 0.041, p = 0.083, p = 0.036, p = 0.010, respectively).

CONCLUSIONS: SIRI values may offer utility as a novel tool for predicting clinical outcomes in naSAH patients during the early stages of disease.