Association of the systemic immune-inflammation index with consciousness disturbance in cerebral venous sinus thrombosis: a retrospective cohort study.
4 affiliations
- 1Department of Neurology, The Second Hospital of Lanzhou University, Lanzhou, China.
- 2Department of Neurology, Xinhua Hospital Affiliated with Dalian University, Dalian, China.
- 3Department of Emergency Intensive Care Unit (ICU), The Affiliated Hospital of Qinghai University, Xining, China.
- 4Emergency Department, Qinghai Provincial People's Hospital, Xining, China.
Abstract
Background
Consciousness disturbance (CD) is a severe neurological manifestation of cerebral venous sinus thrombosis (CVST), but the association between the systemic immune-inflammation index (SII) and CD has not been fully characterised.Methods
This retrospective single-centre cohort included 213 adults with imaging-confirmed CVST, of whom 55 (25.8%) had CD during the acute admission. We applied a four-step variable-selection procedure, a ten-seed LASSO-consensus approach, fixed-feature 3 × 10-fold repeated cross-validation, and full-pipeline nested internal validation as a sensitivity analysis. SII was evaluated continuously, by quartiles, and using restricted cubic splines, with additional confounding, component-comparison, interaction, calibration, and incremental-value analyses.Results
In the exploratory standardised three-predictor model, higher SII (OR 4.68, 95% bootstrap CI 2.98-8.64; P <0.001), intracerebral haemorrhage (OR per 1 SD 1.62, 1.14-2.40; P = 0.008), and lower platelet count (OR 0.39, 0.23-0.57; P <0.001) showed conditional associations with CD. Logistic regression using eight LASSO-consensus features achieved AUROC 0.840 ± 0.092 with a train-test gap of 0.028 in the prespecified fixed-feature repeated cross-validation. A like-for-like fixed-feature logistic-regression comparison showed that the three-predictor model retained similar discrimination to the eight-feature model (mean per-fold AUROC 0.837 ± 0.091 vs. 0.840 ± 0.092) with a smaller train-test gap (0.004 vs. 0.028). The full-pipeline nested sensitivity analysis yielded AUROC 0.800 (95% CI 0.717-0.869). Patients in the highest SII quartile had 11.62-fold higher fully adjusted odds of CD than those in the lowest quartile (95% CI 2.82-47.87; P-trend = 0.0004). The spline supported an overall association (P <0.001) but not statistically significant nonlinearity (P = 0.151). In component sensitivity analyses, SII had greater unadjusted discrimination than neutrophil count, lymphocyte count, or platelet count (AUROC 0.783 vs. 0.638, 0.575, and 0.575, respectively).Conclusions
Higher acute-phase SII was associated with CD in this cohort. The fixed-feature and full-pipeline nested analyses provide complementary internal evidence; prospective, temporally resolved, multicentre external validation is required before clinical use.
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BibTeX
@article{liu2026association,
title = {{Association of the systemic immune-inflammation index with consciousness disturbance in cerebral venous sinus thrombosis: a retrospective cohort study.}},
author = {Xuhui Liu and Zhiqi Yu and Xujie Wang and Rongfei Xie and Ming Hou and Jie Liu},
journal = {Frontiers in immunology},
year = {2026},
month = sep,
doi = {10.3389/fimmu.2026.1881634},
url = {https://europepmc.org/article/MED/42851557},
note = {CC BY},
}
RIS
TY - JOUR
TI - Association of the systemic immune-inflammation index with consciousness disturbance in cerebral venous sinus thrombosis: a retrospective cohort study.
AU - Xuhui Liu
AU - Zhiqi Yu
AU - Xujie Wang
AU - Rongfei Xie
AU - Ming Hou
AU - Jie Liu
PY - 2026
DA - 2026/09/24
JO - Frontiers in immunology
DO - 10.3389/fimmu.2026.1881634
UR - https://europepmc.org/article/MED/42851557
AB - Background Consciousness disturbance (CD) is a severe neurological manifestation of cerebral venous sinus thrombosis (CVST), but the association between the systemic immune-inflammation index (SII) and CD has not been fully characterised.Methods This retrospective single-centre cohort included 213 adults with imaging-confirmed CVST, of whom 55 (25.8%) had CD during the acute admission. We applied a four-step variable-selection procedure, a ten-seed LASSO-consensus approach, fixed-feature 3 × 10-fold repeated cross-validation, and full-pipeline nested internal validation as a sensitivity analysis. SII was evaluated continuously, by quartiles, and using restricted cubic splines, with additional confounding, component-comparison, interaction, calibration, and incremental-value analyses.Results In the exploratory standardised three-predictor model, higher SII (OR 4.68, 95% bootstrap CI 2.98-8.64; P <0.001), intracerebral haemorrhage (OR per 1 SD 1.62, 1.14-2.40; P = 0.008), and lower platelet count (OR 0.39, 0.23-0.57; P <0.001) showed conditional associations with CD. Logistic regression using eight LASSO-consensus features achieved AUROC 0.840 ± 0.092 with a train-test gap of 0.028 in the prespecified fixed-feature repeated cross-validation. A like-for-like fixed-feature logistic-regression comparison showed that the three-predictor model retained similar discrimination to the eight-feature model (mean per-fold AUROC 0.837 ± 0.091 vs. 0.840 ± 0.092) with a smaller train-test gap (0.004 vs. 0.028). The full-pipeline nested sensitivity analysis yielded AUROC 0.800 (95% CI 0.717-0.869). Patients in the highest SII quartile had 11.62-fold higher fully adjusted odds of CD than those in the lowest quartile (95% CI 2.82-47.87; P-trend = 0.0004). The spline supported an overall association (P <0.001) but not statistically significant nonlinearity (P = 0.151). In component sensitivity analyses, SII had greater unadjusted discrimination than neutrophil count, lymphocyte count, or platelet count (AUROC 0.783 vs. 0.638, 0.575, and 0.575, respectively).Conclusions Higher acute-phase SII was associated with CD in this cohort. The fixed-feature and full-pipeline nested analyses provide complementary internal evidence; prospective, temporally resolved, multicentre external validation is required before clinical use.
SN - 1664-3224
ER -