What question did this study set out to answer?

This study aims to evaluate the relationship between systemic immune-inflammatory indices and long-term mortality in acute ischemic stroke patients.

March 10, 2026Open Access

Admission systemic immune-inflammatory index predicts long-term mortality in patients with acute ischemic stroke: a retrospective analysis of the MIMIC-III database

Key Points

This study aims to evaluate the relationship between systemic immune-inflammatory indices and long-term mortality in acute ischemic stroke patients.
Conducted a retrospective cohort study using data from 1222 acute ischemic stroke patients in the MIMIC-III database.
Classified patients into tertiles based on AISI levels (low, medium, and high).
Utilized Cox proportional risk model for estimating relationships between AISI and all-cause mortality.
Performed restricted cubic spline and subgroup analyses for validation.
High AISI patients demonstrated a 31% increased risk of death after 90 days compared to low AISI patients.
Those with high AISI exhibited a 27% increased risk of mortality after 365 days.
There was a 30% increased risk of death after two years in high AISI patients compared to low AISI patients.
Mortality rates increased gradually with rising AISI values after 5841.5.

Abstract

Abstract Background The Aggregate Index of Systemic Inflammation (AISI) is a novel index based on platelets, neutrophils, and lymphocytes associated with the prognosis of patients with cancer and infectious diseases. However, its application in acute ischemic stroke (AIS) has rarely been reported. This study evaluated stroke prognosis using AISI by examining the relationship between levels of systemic immunoinflammatory indices at admission and patient outcomes at different times after onset. Methods This was a retrospective cohort study. The data from 1222 stroke patients were obtained from multiparameter intelligent monitoring in the Intensive Care III database (MIMIC-III). Cox proportional risk model was conducted to estimate the relation between AISI, all-cause mortality, and ischemic. The findings were further validated with restricted cubic spline (RCS) and subgroup analyses. Results A total of 1222 patients with AIS were classified into tertiles based on AISI levels, tertile 1: low AISI, AISI levels less than 3881 ( n = 408), tertile 2: medium AISI, AISI levels 3881 to 8354 ( n = 408), and tertile 3: high AISI, AISI levels greater than 8354 ( n = 407). After adjusting for multiple covariates, it was found that AISI was related to all-cause mortality in stroke patients. Patients with high AISI had a 31% increased risk of death after 90 days (HR = 1.31, 95% CI 1.03–1.67, P = 0.03) compared to patients with low AISI. Patients with high AISI had a 27% increased risk of death after 365 days (HR = 1.27, 95% CI 1.03–1.58, P = 0.029) than low AISI patients. Furthermore, compared with patients with low AISI, patients with high AISI had a 30% increased risk of death after two years (HR = 1.30, 95% CI 1.05–1.60, P = 0.014). During the 2-year follow-up period, the use of RCS showed that the mortality rate gradually increased with the increase of AISI value after 5841.5. Conclusion Systemic immunoinflammatory indices are related to long-term adverse outcomes in patients with AIS. Therefore, AISI is a promising inflammatory index for predicting the long-term prognosis of stroke.

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Cite This Study

Su et al. (Mon,) studied this question.

synapsesocial.com/papers/69af959570916d39fea4d4df https://doi.org/https://doi.org/10.1186/s40635-026-00878-5

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