To explore the role of SIRI in the prognosis of critically ill patients with spontaneous intracranial haemorrhage, including mortality and secondary complications such as sepsis and pneumonia.

Intracerebral hemorrhage is characterised by significant morbidity and mortality. Inflammatory mechanisms play a crucial role in the progression of ICH, dictating both acute and chronic outcomes of the disease. Indices such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), red cell distribution width (RDW) and systemic inflammatory response index (SIRI) play a pivotal role in the inflammatory response following ICH. This study aims to compare the predictive value of SIRI with NLR, PLR, LMR and RDW to determine its application in prognosis of critically ill ICH patients.

In this retrospective cohort study, data was obtained from 140 patients admitted to the Intensive Care Unit having suffered an acute ICH between March 2023 to March 2024. Spearman’s correlation coefficient was used to evaluate the relationship between SIRI and NIHSS. Receiver Operating curve (ROC) analysis was used to determine the predictive power of SIRI compared to NLR, PLR, LMR and RDW for the prognosis of ICH.

Elevated SIRI was accompanied by higher mortality. Spearman’s correlation coefficient established a significant positive correlation between SIRI and NIHSS. After adjusting multiple covariates, ROC analysis revealed SIRI had the highest predictive value for the outcomes – mortality (AUC-0.722) and Sepsis (AUC-0.606). Furthermore, the area under curve of SIRI was significantly greater than for LMR and PLR. However, there was no statistically significant difference between SIRI versus NLR and RDW.

Rising SIRI was associated with a higher stroke severity and higher risk of mortality. SIRI proves to be an effective predictor of mortality risk among critically ill patients with ICH.