Yongho Kwon, Ho Jun Yi, Dong-Seong Shin, Bum-Tae Kim
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引用次数: 0
Abstract
Objective: The Pan-Immune-Inflammation Value (PIV) is a novel composite biomarker that reflects systemic inflammatory status. This study aimed to assess the prognostic value of preoperative PIV in predicting recurrence after burr hole drainage (BHD) in patients with chronic subdural hematoma (CSDH).
Methods: We conducted a retrospective analysis of 521 patients who underwent BHD for CSDH between January 2015 and October 2025. Preoperative inflammatory markers, including PIV, the systemic Immune-Inflammation Index (SII), and the systemic Inflammation Response Index (SIRI), were calculated. We performed receiver operating characteristic (ROC) curve analysis and multivariate logistic regression to identify predictive factors for recurrence after BHD.
Results: Recurrence was observed in 123 patients (23.6%). The recurrence group had a significantly higher mean PIV value compared to the non-recurrence group (481.8 ± 211.2 vs. 259.4 ± 164.7, p = 0.020). ROC analysis showed that PIV had the highest predictive accuracy for recurrence, with an area under the curve of 0.801 (95% confidence interval [CI] 0.753-0.850; p < 0.001). The optimal cutoff value for PIV to predict recurrence after BHD was determined to be 311.4. In multivariate analysis, elevated SII (≥ 551.2) (odds ratio [OR] 1.12, 95% CI 1.06-1.38; p = 0.048) and elevated PIV (≥ 311.4) (OR 1.28, 95% CI 1.08-1.86; p = 0.022) were identified as independent predictors of recurrence after BHD.
Conclusion: Preoperative PIV is a strong, independent predictor of CSDH recurrence following BHD. Further research is needed to validate the prognostic role of PIV in patients with CSDH.
目的：泛免疫炎症值（Pan-Immune-Inflammation Value， PIV）是一种反映全身炎症状态的新型复合生物标志物。本研究旨在评估术前PIV对慢性硬膜下血肿（CSDH）患者钻孔引流（BHD）后复发的预测价值。方法：我们对2015年1月至2025年10月期间因CSDH接受BHD治疗的521例患者进行了回顾性分析。计算术前炎症指标，包括PIV、全身免疫炎症指数（SII）和全身炎症反应指数（SIRI）。我们通过受试者工作特征（ROC）曲线分析和多变量logistic回归来确定BHD后复发的预测因素。结果：123例患者复发，占23.6%。复发组的平均PIV值明显高于未复发组（481.8±211.2∶259.4±164.7,p = 0.020）。ROC分析显示，PIV对复发的预测准确率最高，曲线下面积为0.801（95%可信区间[CI] 0.753-0.850; p < 0.001）。PIV预测BHD复发的最佳临界值为311.4。在多变量分析中，SII升高（≥551.2）（比值比[OR] 1.12, 95% CI 1.06-1.38; p = 0.048）和PIV升高（≥311.4）（比值比[OR] 1.28, 95% CI 1.08-1.86; p = 0.022）被确定为BHD复发的独立预测因子。结论：术前PIV是BHD后CSDH复发的一个强有力的独立预测因子。需要进一步的研究来验证PIV在CSDH患者中的预后作用。
期刊介绍：
The Journal of Korean Neurosurgical Society (J Korean Neurosurg Soc) is the official journal of the Korean Neurosurgical Society, and published bimonthly (1st day of January, March, May, July, September, and November). It launched in October 31, 1972 with Volume 1 and Number 1. J Korean Neurosurg Soc aims to allow neurosurgeons from around the world to enrich their knowledge of patient management, education, and clinical or experimental research, and hence their professionalism. This journal publishes Laboratory Investigations, Clinical Articles, Review Articles, Case Reports, Technical Notes, and Letters to the Editor. Our field of interest involves clinical neurosurgery (cerebrovascular disease, neuro-oncology, skull base neurosurgery, spine, pediatric neurosurgery, functional neurosurgery, epilepsy, neuro-trauma, and peripheral nerve disease) and laboratory work in neuroscience.
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