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High SII at admission linked to 2.14-fold increased risk of post-stroke depressionHigh SII levels at admission linked to higher stroke depression risk in adults

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Key Takeaway
Consider using SII at admission as a biomarker to identify stroke patients at higher risk for post-stroke depression.

This meta-analysis pooled data from 2,780 adult stroke patients across multiple studies to evaluate the association between the systemic immune-inflammation index (SII) at admission and the risk of post-stroke depression (PSD). The primary outcome was the development of PSD, which occurred in 822 patients. The analysis found that a high SII was significantly associated with an increased risk of PSD, with a pooled odds ratio of 2.14 (95% CI: 1.74–2.64; I² = 22%). The authors note that the association remained consistent across study design, stroke type, age, sex proportion, SII cutoff method, cutoff value, PSD assessment tool, and study quality. Limitations include the observational nature of the included studies, which precludes causal inference, and the lack of reported follow-up duration and adverse events. The authors suggest that SII may serve as a simple and accessible inflammatory biomarker for early identification of patients at higher risk of developing PSD, though further prospective studies are needed to validate this finding.

A major review looked at data from almost three thousand adults who had a stroke. The team checked a specific inflammation marker called SII right after the stroke happened. They compared people with high levels of this marker to those with lower levels.

Patients with higher SII scores were much more likely to feel depressed later on. About eight hundred twenty two people in the group developed post-stroke depression. The study showed that high inflammation was connected to a significantly greater risk of this mood problem.

The link between inflammation and depression held true across different types of strokes and ages. It did not matter if the study was small or large. This finding suggests that checking SII levels is a useful way to find patients at risk early.

Doctors might use this simple test to identify who needs extra support. Finding these patients sooner could lead to better treatment plans and improved recovery for everyone affected by a stroke.

What this means for you:
High inflammation markers at stroke admission double the risk of later depression, helping doctors find at-risk patients early.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJun 2026
View Original Abstract ↓
BackgroundPost-stroke depression (PSD) is a common neuropsychiatric complication that adversely affects recovery and prognosis after stroke. The systemic immune-inflammation index (SII), a composite biomarker derived from peripheral blood counts, reflects systemic inflammatory status and has been associated with adverse neurological outcomes. However, the relationship between SII and PSD remains uncertain. We conducted a meta-analysis to clarify this association.MethodsPubMed, Embase, Web of Science, Wanfang, and CNKI were searched for observational studies evaluating the association between SII and PSD in adult stroke patients. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using a random-effects model by incorporating the potential influence of heterogeneity.ResultsSeven studies involving 2,780 patients were included, among whom 822 developed PSD. Compared with lower SII levels, high SII at admission was significantly associated with an increased risk of PSD (OR = 2.14, 95% CI: 1.74–2.64; I² = 22%). Sensitivity analyses by excluding one study at a time showed similar results (pooled OR range: 2.06–2.38, all p-values < 0.05), which confirmed the stability of the findings. The association remained consistent across study design, stroke type, age, sex proportion, SII cutoff method, cutoff value, PSD assessment tool, and study quality (all p for subgroup differences > 0.05).ConclusionsElevated SII may be independently associated with an approximately twofold increased risk of PSD. SII may serve as a simple and accessible inflammatory biomarker for early identification of patients at higher risk of developing PSD.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD420261326749.
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