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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Neurotrauma
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1439318

Trajectories of systemic immune inflammation index and mortality risk in patients with moderate-to-severe traumatic brain injury: A retrospective cohort study

Provisionally accepted
Zhiyong Tang Zhiyong Tang 1,2Canlin Liao Canlin Liao 1Zerui Zhuang Zerui Zhuang 1Zhennan Xu Zhennan Xu 1Ming Fa Liu Ming Fa Liu 1*Haixiong Xu Haixiong Xu 1*
  • 1 Department of Neurosurgery, Shantou Central Hospital, Shantou, China
  • 2 Other, Guangzhou, China

The final, formatted version of the article will be published soon.

    Background: Some studies have shown a strong link between the central nervous system and peripheral immune system, but the prognostic implications of dynamic peripheral immuneinflammatory 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.Methods: This 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.Results: A 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: 83.8%, and specificity: 75.0% for mortality in this cohort.This 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

    Keywords: Traumatic brain injury (TBI), Neuroinflammation, group-based trajectory modeling (GBTM), Inflammatory biomarkers, Systemic immune inflammation index (SII), all-cause hospital mortality

    Received: 27 May 2024; Accepted: 31 Dec 2024.

    Copyright: © 2024 Tang, Liao, Zhuang, Xu, Liu and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Ming Fa Liu, Department of Neurosurgery, Shantou Central Hospital, Shantou, China
    Haixiong Xu, Department of Neurosurgery, Shantou Central Hospital, Shantou, China

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