Abstract: Objective To analyze the correlation between inflammation indicators(systemic inflammatory response syndrome and systemic immune-inflammation index) and adverse outcomes in patients with symptomatic stroke during hospitalization. Methods This study was a prospective cohort study including consecutive patients with symptomatic stroke who were hospitalized in Fuwai Hospital from January to September 2023. The past medical history, clinical symptoms and signs of the patients were collected. The neurological damage was evaluated with National Institute of Health Stroke Scale(NIHSS). Laboratory test results were recorded and the SIRI and SII index were calculated. Patients were followed up for 90 days after the stroke, and their neurological outcomes were evaluated using the modified Rankin Scale. A score of 0-1 was classified as good outcome, and a score ≥2 was classified as poor outcome. The correlation between inflammatory response indicators and poor outcomes was assessed using multiple Logistic regression. Results A total of 97 patients with in-hospital symptomatic stroke were included with an average age of 61.8±12.7 years. Among them, there were 28 females(28.9%, 28/97), 9 with a history of prior stroke(9.3%, 9/97), 15 with atrial fibrillation(15.5%, 15/97), 16 with heart failure(16.5%, 16/97), and 7 with myocardial infarction(7.2%, 7/97). Correlation analysis showed that the NIHSS score at the time of stroke onset was significantly correlated with the patient's post-stroke SIRI(r=0.237, P＜0.05) and SII(r=0.234, P＜0.05). After 90 days of follow-up, 41 cases (42.3%, 41/97) had a poor outcome. Multiple Logistic regression analysis showed that post-stroke SIRI(Or=4.71, 95% CI:1.24-17.90) and SII(Or=3.13, 95% CI:0.88-11.06) were correlated with poor outcomes within 90 days after the stroke. Analysis using restricted cubic splines showed that as the levels of SIRI and SII increased, the risk of poor outcomes in patients with in-hospital symptomatic stroke increased. Conclusions SIRI is an independent risk factor for poor outcomes in patients with in-hospital symptomatic stroke, and the risk of poor neurological outcomes increases with high level of SIRI.

Key words: in-hospital stroke, systemic inflammatory response syndrome, systemic immune-inflammation index, national institute of health stroke scale, poor prognosis.