Jie Li ^1* Ping Zhang ¹ HONG CHEN ¹ Yanfen Wang ¹ Yangyun Han ² Chun Wang ¹ Xingyang Yi ¹

• ¹ Department of Neurology, People’s Hospital of Deyang City, Deyang, China
• ² Sichuan Clinical Research Center for Neurological Diseases, Deyang, China

Objectives: Patients with minor ischemic stroke (MIS) have substantial disability rates at 90 days. Our study aimed to explore the association between systemic inflammation response index (SIRI) and 3-month functional outcomes in patients with MIS.We conducted a prospective observational study in patients with MIS [defined as a National Institutes of Health Stroke Scale (NIHSS) score 0-3] admitted within 24 hours from symptoms onset. Blood samples for SIRI measurement were collected on admission. The primary outcome measure was poor outcomes at 90 days (defined as modified Rankin Scale score 2-6). Univariate and multivariate logistic analyses were performed to assess the association between SIRI with the risk of 3month poor outcomes.A total of 152 patients with MIS were enrolled, of which 24 cases (15.8%) had poor outcomes at 90 days. The median SIRI level was 1.27 [interquartile range (IQR), 0.77-1.92, ×10^9 /L] on admission. MIS patients with poor outcomes had a higher level of SIRI compared with those patients with good outcomes (poor outcomes: median 1.93, IQR 1.17-3.28, ×10^9 /L; good outcomes: median 1.21, IQR 0.71-1.80, ×10^9 /L; p=0.003). The high SIRI level group (SIRI >1.27 ×10^9 /L) had a significant higher rate of poor outcomes at 90 days (22.4% vs. 9.2%, p=0.026). After adjusting for age, baseline NIHSS score, prehospital delay, TOAST classification, and other confounders in multivariate analyses, elevated SIRI level remained independently associated with an increased risk of poor outcomes in patients with MIS [odds ratio (OR) 1.57, 95% confidence interval (CI) 1.12-2.20; p=0.010]. Meanwhile, high level of SIRI (>1.27 ×10^9 /L) was still an independent risk factor for 3-month poor outcomes (OR 4.80, 95%CI 1.51-15.29; p=0.008) in MIS patients.Conclusions: Disability at 90 days was common in patients with MIS. Elevated SIRI was associated with poor outcomes in MIS patients. SIRI might be a promising biomarker candidate that can help identify high-risk MIS patients with poor outcomes, for reaching individual therapeutic decisions in clinical trials.