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Brain Sciences
Volume 16
Issue 7
10.3390/brainsci16070666
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Prognostic Value of Systemic Immune-Inflammation Index for Early Mortality After Decompressive Craniectomy in Malignant Middle Cerebral Artery Infarction

by
Yasin Taşkın
1,*,
Özgür Demir
1,
Veysel Kıyak
1,
Mustafa Arslan
2,
Övgü Can Ünal
1 and
Yunus Emre Kuyucu
3
1
Department of Neurosurgery, Tokat Gaziosmanpaşa University, 60030 Tokat, Turkey
2
Department of Neurosurgery, Gaziantep City Hospital, 27470 Gaziantep, Turkey
3
Department of Biostatistics, Faculty of Medicine, Tokat Gaziosmanpaşa University, 60030 Tokat, Turkey
*
Author to whom correspondence should be addressed.
Brain Sci. 2026, 16(7), 666; https://doi.org/10.3390/brainsci16070666 (registering DOI)
Submission received: 22 May 2026 / Revised: 11 June 2026 / Accepted: 22 June 2026 / Published: 25 June 2026
(This article belongs to the Section Neurosurgery and Neuroanatomy)
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Abstract

Objective: Malignant middle cerebral artery infarction is associated with high mortality despite decompressive craniectomy. Reliable biomarkers predicting early outcome remain limited. The aim of this study was to evaluate the prognostic significance of inflammatory biomarkers, particularly the systemic immune–inflammation index (SII), for predicting in-hospital mortality in patients undergoing decompressive craniectomy for malignant middle cerebral artery infarction. Methods: This retrospective study included 31 patients who underwent decompressive craniectomy for malignant MCA infarction between 2014 and 2024. Demographic, clinical, radiological, and laboratory variables were analyzed. Results: Overall in-hospital mortality was 61.3%. Non-survivors had significantly higher SII, neutrophil count, neutrophil-to-lymphocyte ratio, serum creatinine, and higher prevalence of hypertension and anticoagulant therapy. ROC analysis showed that SII had the highest predictive performance (AUC = 0.833). Multivariate analysis identified age, serum creatinine, NLR, SII, hypertension, and anticoagulant therapy as independent predictors of mortality. Patients aged ≥65 years had significantly higher in-hospital mortality than younger patients. Conclusions: Elevated SII is a strong independent predictor of early mortality after decompressive craniectomy and may serve as a simple and clinically applicable biomarker for risk stratification.
Keywords: malignant MCA infarction; decompressive craniectomy; systemic immune-inflammation index; neutrophil-lymphocyte ratio; mortality malignant MCA infarction; decompressive craniectomy; systemic immune-inflammation index; neutrophil-lymphocyte ratio; mortality
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MDPI and ACS Style

Taşkın, Y.; Demir, Ö.; Kıyak, V.; Arslan, M.; Ünal, Ö.C.; Kuyucu, Y.E. Prognostic Value of Systemic Immune-Inflammation Index for Early Mortality After Decompressive Craniectomy in Malignant Middle Cerebral Artery Infarction. Brain Sci. 2026, 16, 666. https://doi.org/10.3390/brainsci16070666

AMA Style

Taşkın Y, Demir Ö, Kıyak V, Arslan M, Ünal ÖC, Kuyucu YE. Prognostic Value of Systemic Immune-Inflammation Index for Early Mortality After Decompressive Craniectomy in Malignant Middle Cerebral Artery Infarction. Brain Sciences. 2026; 16(7):666. https://doi.org/10.3390/brainsci16070666

Chicago/Turabian Style

Taşkın, Yasin, Özgür Demir, Veysel Kıyak, Mustafa Arslan, Övgü Can Ünal, and Yunus Emre Kuyucu. 2026. "Prognostic Value of Systemic Immune-Inflammation Index for Early Mortality After Decompressive Craniectomy in Malignant Middle Cerebral Artery Infarction" Brain Sciences 16, no. 7: 666. https://doi.org/10.3390/brainsci16070666

APA Style

Taşkın, Y., Demir, Ö., Kıyak, V., Arslan, M., Ünal, Ö. C., & Kuyucu, Y. E. (2026). Prognostic Value of Systemic Immune-Inflammation Index for Early Mortality After Decompressive Craniectomy in Malignant Middle Cerebral Artery Infarction. Brain Sciences, 16(7), 666. https://doi.org/10.3390/brainsci16070666

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