Systemic inflammatory response syndrome and adverse outcomes in acute intracerebral hemorrhage: a meta-analysis.

OBJECTIVE

Systemic inflammatory response syndrome (SIRS) frequently complicates acute intracerebral hemorrhage (ICH) and may affect patient prognosis. However, the prognostic value of SIRS in patients with acute ICH remains controversial. This meta-analysis aimed to assess the prognostic significance of SIRS in this patient population.

METHODS

We systematically searched PubMed, Embase, and Web of Science to identify studies investigating the associations between SIRS and adverse outcomes-namely mortality, poor functional outcome (PFO), and hematoma expansion-in patients with acute ICH. Pooled adjusted odds ratios (OR) with 95% confidence intervals (CI) were synthesized using a random-effects model.

RESULTS

Nine studies enrolling a total of 6,976 patients with acute ICH were included. Meta-analyses revealed that patients with acute ICH complicated by SIRS exhibited a substantially higher risk of short-term mortality (OR 2.43; 95% CI 1.48-3.99) relative to patients without SIRS. SIRS was also associated with increased risks of PFO at 3 months (OR 1.47; 95% CI 1.15-1.88) and at 12 months (OR 1.76; 95% CI 1.16-2.68), whereas no significant association was observed for PFO at hospital discharge (OR 2.41; 95% CI 0.69-8.44). Moreover, SIRS was associated with a significantly higher risk of hematoma expansion (OR 2.76; 95% CI 1.68-4.54).

CONCLUSIONS

The development of SIRS is associated with increased risks of short-term mortality, PFO, and hematoma expansion in acute ICH patients. However, these findings should be considered exploratory due to the limited number of prior studies. Large prospective investigations are needed to validate these results and clarify the potential clinical utility of SIRS assessment.