AbstractBackground Although growing evidence elucidated the occurrence of inflammatory alterations in brain arteriovenous malformation (AVM), the role of inflammatory indices in clinical outcomes remained unrecognized. This study aimed to explore the characteristics of systemic inflammatory biomarkers and their associations with the neurological prognosis in patients with AVM. Methods AVM patients from a prospective cohort study between June 2016 and June 2020 were reviewed. The unfavorable outcome was defined as a modified Rankin scale (mRS) > 2 at discharge. The associations of systemic inflammatory biomarkers (neutrophil count NEUT, neutrophil-to-lymphocyte ratio NLR, systemic immune-inflammation index SII, aggregate index of systemic inflammation AISI) with unfavorable outcome were determined. Results A total of 360 AVM patients were included. Inflammatory biomarkers were noticeably higher in patients with unfavorable outcome. The individual inflammatory indicators of NEUT (OR 1.153, p = 0.005), NLR (OR 1.103, p = 0.030), SII (OR 1.001, p = 0.003), and AISI (OR 1.001, p = 0.021) were independently associated with the unfavorable outcome. Receiver operating characteristic curves of the multivariate regression models showed prominent performance in the prediction of unfavorable outcome (NEUT, AUC = 0.865; NLR, AUC = 0.861; SII, AUC = 0.864; AISI, AUC = 0.862). The associations between inflammatory biomarkers and unfavorable outcome were more prominent among ruptured AVM and patients with volume 3. Conclusions This study underscored the significant role of inflammation in predicting neurological outcomes in AVM, providing novel insights into the pathophysiological mechanisms of adverse prognosis and offering opportunities for early screening and therapeutic management of neurological deficits in AVM patients. Registration URL: https://clinicaltrials.gov NCT03774017.
Jiang et al. (Sun,) studied this question.