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已发表论文
系统免疫炎症指数与 2 型糖尿病合并自发性脑出血患者院内及长期全因死亡率的关联
Authors Shen Y, Gao A, Shen Y, Gao S, Rong Y, Fan Z, Li Q, Lin T, Yang S, Liang H
Received 25 June 2025
Accepted for publication 21 December 2025
Published 10 January 2026 Volume 2026:19 549520
DOI https://doi.org/10.2147/JIR.S549520
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Quan Zhang
Yongze Shen,1,* Aili Gao,2,* Yingjie Shen,1 Shang Gao,1 Yiwei Rong,1 Zhaoxin Fan,1 Qi Li,1 Tie Lin,1 Shanshan Yang,3 Hongsheng Liang1
1Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, People’s Republic of China; 2School of Life Science, Northeast Agricultural University, Harbin, 150006, People’s Republic of China; 3Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Shanshan Yang; Hongsheng Liang, Email yangshanshan81@hrbmu.edu.cn; lianghongsheng@hrbmu.edu.cn
Objective: Patients with type 2 diabetes mellitus (T2DM) and spontaneous intracerebral hemorrhage (sICH) face high mortality. Systemic inflammation may play a key role, but the prognostic value of the systemic immune-inflammation index (SII) in this population remains unclear. This study aimed to investigate the association between SII and all-cause mortality in T2DM with sICH.
Methods: A retrospective cohort study was conducted on 891 patients with T2DM and sICH hospitalized at the First Affiliated Hospital of Harbin Medical University from January 2021 to December 2024. SII was calculated using the formula: platelet count × neutrophil count/lymphocyte count. Patients were categorized into high and low SII groups based on the median value (817.5). Kaplan-Meier survival analysis, multivariate logistic and Cox regression models were used to assess the association of SII with in-hospital and long-term mortality. Subgroup and sensitivity analyses were performed to test the robustness of findings. Receiver operating characteristic (ROC) curves further evaluated predictive performance.
Results: In fully adjusted models, high SII was independently associated with a significantly increased risk of in-hospital mortality (OR = 3.122, 95% CI: 1.759– 5.544, P < 0.001) and long-term all-cause mortality (median follow-up 20.6 months, HR = 2.755, 95% CI: 1.938– 3.919, P < 0.001). Each 1-standard deviation increase in SII was linked to a 75.9% higher in-hospital death risk (OR = 1.759), and a 17.0% increase in long-term mortality risk (HR = 1.170). ROC analysis demonstrated moderate discriminative ability for SII (AUC = 0.722 for in-hospital mortality, AUC = 0.748 for long-term mortality). Kaplan-Meier analysis revealed significantly poorer survival in the high SII group over a 50-month follow-up (log-rank P = 0.015). These associations remained stable across subgroups and after adjusting for confounding comorbidities and clinical parameters.
Conclusion: Elevated SII is an independent predictor of both in-hospital and long-term all-cause mortality in patients with T2DM and sICH. This may be because high SII reflects an imbalance of inflammation and immunity, leading to increased mortality risk.
Keywords: systemic immune-inflammation index, type 2 diabetes mellitus, spontaneous intracerebral hemorrhage, mortality, prognostic biomarker
1Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, People’s Republic of China; 2School of Life Science, Northeast Agricultural University, Harbin, 150006, People’s Republic of China; 3Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Shanshan Yang; Hongsheng Liang, Email yangshanshan81@hrbmu.edu.cn; lianghongsheng@hrbmu.edu.cn
Objective: Patients with type 2 diabetes mellitus (T2DM) and spontaneous intracerebral hemorrhage (sICH) face high mortality. Systemic inflammation may play a key role, but the prognostic value of the systemic immune-inflammation index (SII) in this population remains unclear. This study aimed to investigate the association between SII and all-cause mortality in T2DM with sICH.
Methods: A retrospective cohort study was conducted on 891 patients with T2DM and sICH hospitalized at the First Affiliated Hospital of Harbin Medical University from January 2021 to December 2024. SII was calculated using the formula: platelet count × neutrophil count/lymphocyte count. Patients were categorized into high and low SII groups based on the median value (817.5). Kaplan-Meier survival analysis, multivariate logistic and Cox regression models were used to assess the association of SII with in-hospital and long-term mortality. Subgroup and sensitivity analyses were performed to test the robustness of findings. Receiver operating characteristic (ROC) curves further evaluated predictive performance.
Results: In fully adjusted models, high SII was independently associated with a significantly increased risk of in-hospital mortality (OR = 3.122, 95% CI: 1.759– 5.544, P < 0.001) and long-term all-cause mortality (median follow-up 20.6 months, HR = 2.755, 95% CI: 1.938– 3.919, P < 0.001). Each 1-standard deviation increase in SII was linked to a 75.9% higher in-hospital death risk (OR = 1.759), and a 17.0% increase in long-term mortality risk (HR = 1.170). ROC analysis demonstrated moderate discriminative ability for SII (AUC = 0.722 for in-hospital mortality, AUC = 0.748 for long-term mortality). Kaplan-Meier analysis revealed significantly poorer survival in the high SII group over a 50-month follow-up (log-rank P = 0.015). These associations remained stable across subgroups and after adjusting for confounding comorbidities and clinical parameters.
Conclusion: Elevated SII is an independent predictor of both in-hospital and long-term all-cause mortality in patients with T2DM and sICH. This may be because high SII reflects an imbalance of inflammation and immunity, leading to increased mortality risk.
Keywords: systemic immune-inflammation index, type 2 diabetes mellitus, spontaneous intracerebral hemorrhage, mortality, prognostic biomarker