Association of systemic inflammation response index with postoperative clinical outcomes among operated patients with aortic dissection: a systematic review with meta-analysis.

BACKGROUND

The association of preoperative systemic inflammation response index (SIRI) with postoperative clinical outcomes in aortic dissection (AD) patients remains unclear. This study aimed to identify the prognostic role of preoperative SIRI in AD patients undergoing the surgery.

METHODS

PubMed, Chinese National Knowledge Infrastructure (CNKI) and Web of Science databases were searched up to February 9, 2026. Primary outcomes included the risk of aorta-related adverse event (ARAE), major adverse event (MAE) and in-hospital mortality. Secondary outcomes included the specific postoperative complications and adverse events such as the acute kidney injury (AKI), renal failure and infection. Relative risk (RR) with 95% confidence interval (CI) was combined.

RESULTS

Eight studies with 2,404 patients were included (type A AD: n=1,295; type B AD: n=1,109). Pooled results indicated that elevated SIRI was significantly related to increased risk of ARAE (RR =2.80, 95% CI: 2.12-3.69, P<0.001) and subgroup analysis by the type of AD revealed consistent findings (type A: RR =2.25, P=0.04; type B: RR =2.94, P<0.001). However, no significant association of SIRI with MAE (RR =1.86, P=0.19) or in-hospital mortality (RR =2.38, P=0.34) was observed. For secondary outcomes, elevated SIRI was related to increased risk of AKI (RR =2.82, P<0.001), renal failure (RR =3.895, P<0.001), infection (RR =1.780, P=0.02), acute hepatic disfunction (RR =8.919, P=0.002), permanent neurological dysfunction (RR =2.180, P=0.005), low cardiac output syndrome (RR =2.812, P=0.006), gastrointestinal bleeding (RR =4.339, P<0.001) and distal aortic negative remodeling (RR =1.39, P=0.01).

CONCLUSIONS

Elevated preoperative SIRI was associated with worse postoperative clinical outcomes such as the ARAE and AKI among AD patients and might contribute to postoperative risk assessment and clinical management of patients with AD.