The Predictive Value of the Systemic Immune-inflammation Index as a New Prognostic Marker for Disability in Patients with Multiple Sclerosis

Abstract

Objective: Multiple sclerosis (MS) is a condition involving central nervous system invasion by immune-inflammatory cells. In this study, we investigated whether the systemic immune-inflammation index (SII) could predict disability cross-sectionally as a novel and useful tool in patients with MS.

Materials and Methods: We retrospectively reviewed the medical records of 148 patients with MS and 84 healthy controls and gathered the relevant clinicallaboratory data. SII in the remission period was calculated using the equation (SII: Platelet count x neutrophil count/lymphocyte count). The odds ratio of each immune formulation index was calculated by logistic regression analysis. In addition, the cut-off value, sensitivity and specificity of SII were calculated using receiver operating characteristics curve analysis.

Results: Age and sex characteristics were similar in the groups (p>0.05). All values obtained through complete blood counts were significantly lower in the patient group (p<0.05). It was seen that the Expanded Disability Status scale (EDSS) was particularly correlated with the neutrophil-lymphocyte ratio and SII (p=0.013, 0.037 rho: 0.225, 0.192, respectively). In addition, we found that SII [ExpB: 0.015, 95% confidence interval: (0.999-1.003); p<0.001] was associated with disease disability in the MS groups formed according to EDSS. Furthermore, the cut-off value for SII was 254.51 x10³/ul with 37% specificity and 95.5% sensitivity.

Conclusion: A high SII may be a promising prognostic marker that is an easily available, inexpensive, and effective tool for predicting the disease disability in MS. Future studies with a larger number of patients may confirm our results.

The study protocol was approved by the Yozgat Bozok University Faculty of Medicine Ethics Committee (decision no: 2017-KAEK189_2020.02.26_12, date: 26.02.2020).

Retrospective study.

Externally and internally peer-reviewed.

Concept: H.S., Design: H.S., T.A., Data Collection or Processing: H.S., T.A., Analysis or Interpretation: H.S., N.T., Literature Search: H.S., Writing: H.S.

No conflict of interest was declared by the authors.

The authors declared that this study received no financial support.