Systemic immune-inflammation index (SIRI) showed a relatively strong association with PSE risk and moderate discriminative ability in the stroke population, and may serve as an auxiliary reference indicator for early risk stratification of post-stroke epilepsy.
Each one-standard-deviation increase in SIRI was associated with a 172% increased risk of post-stroke epilepsy.
SIRI demonstrated the best discriminative ability for PSE among the six inflammatory indices examined.
The association between SIRI and PSE risk was consistent across different patient subgroups.
The study included 317 PSE patients matched 1:1 with 317 stroke patients without PSE using propensity score matching.
Nonlinear relationships and threshold effects between inflammatory indices and PSE risk were explored using restricted cubic spline regression.
SIRI's strength of association with PSE was superior to that of all other inflammation-derived indices studied.
This research suggests that a blood-test-derived measure of immune system activity called the Systemic Immune-Inflammation Index (SIRI) is meaningfully linked to the risk of developing epilepsy after a stroke — a condition known as post-stroke epilepsy (PSE). The study compared 317 stroke patients who developed PSE with 317 stroke patients who did not, carefully matching the two groups by age, sex, and other health conditions. The researchers found that higher SIRI values at hospital admission were strongly associated with greater PSE risk, and this relationship appeared consistent across different patient groups. SIRI outperformed five other commonly used inflammation markers in predicting PSE risk. The SIRI is calculated from routine blood tests that are already taken when patients arrive at the hospital, meaning it would require no additional testing to implement. This makes it a potentially practical and low-cost tool for identifying stroke patients who may be at higher risk of developing epilepsy later on. However, while the association was statistically robust, the test's ability to distinguish between those who will and won't develop PSE was only moderate (AUC of 0.693), meaning it would not be sufficient as a standalone diagnostic tool. This research suggests that inflammation-related blood markers, particularly SIRI, could serve as useful supplementary indicators to help clinicians flag high-risk patients for closer monitoring after stroke. The authors caution that the findings come from a single hospital's retrospective data and that prospective studies are needed before SIRI can be routinely recommended for PSE risk stratification in clinical practice.
Wang Y, Gao Y, Wang L. (2026). Association Between Multiple Inflammation-Derived Indices and the Risk of Post-Stroke Epilepsy.. CNS neuroscience & therapeutics. https://doi.org/10.1002/cns.71143