{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T22:31:10Z","timestamp":1791498670915,"version":"4.3.4"},"reference-count":51,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T00:00:00Z","timestamp":1787356800000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["CNS Neurosci Ther"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Long\u2010term stay (LTS) in the neurosurgical intensive care unit (Neuro\u2010ICU) after supratentorial brain tumor resection disproportionately consumes healthcare resources, but early risk stratification tools remain lacking. We evaluated five early postoperative inflammatory indices (neutrophil\u2010to\u2010lymphocyte ratio [NLR], platelet\u2010to\u2010lymphocyte ratio [PLR], lymphocyte\u2010to\u2010monocyte ratio [LMR], systemic immune\u2010inflammation index [SII], and systemic inflammation response index [SIRI]) to develop an integrated prediction model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective study included patients requiring &gt;\u200948\u2010h Neuro\u2010ICU care after elective supratentorial tumor resection. Patients were temporally partitioned into derivation (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009432) and validation (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009146) cohorts. Inflammatory indices were measured within 24\u2009h postoperatively. Following least absolute shrinkage and selection operator (LASSO) feature selection, five machine learning classifiers were compared. Model performance was assessed for discrimination, calibration, and clinical utility, alongside subgroup analyses and a series of sensitivity analyses. A nomogram and web\u2010based risk calculator were developed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      LTS occurred in 47.5% and 49.3% of the derivation and validation cohorts, respectively. LTS patients showed higher early postoperative SIRI and PLR and lower LMR, whereas preoperative indices did not differ. All three were independent predictors of LTS. The integrated model combined these indices with preoperative Karnofsky Performance Status, postoperative steroid use, and retained endotracheal intubation at blood sampling. It yielded an AUC of 0.845 in the derivation cohort and 0.816 in the validation cohort, compared with 0.715 for the clinical baseline model (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; IDI 0.212; cNRI 0.981). These indices maintained independent predictive value, and model performance remained stable across subgroup and sensitivity analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Early postoperative SIRI, PLR, and LMR independently predict LTS in patients requiring prolonged care (&gt;\u200948\u2009h) after supratentorial brain tumor resection. An integrated model with these indices and early clinical variables provides reliable risk stratification within 24 postoperative hours.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cns.71100","type":"journal-article","created":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T08:01:19Z","timestamp":1787385679000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Early Postoperative Inflammatory Indices Predict Long\u2010Term Neuro\u2010\n                    <scp>ICU<\/scp>\n                    Stay in Patients Requiring Prolonged Care After Supratentorial Brain Tumor Resection: Development and Validation of an Integrated Model"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6153-7862","authenticated-orcid":false,"given":"Biwu","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Neurosurgical Intensive Care Unit, Huashan Hospital Fudan University  Shanghai China"},{"name":"Department of Neurosurgery, Huashan Hospital Fudan University  Shanghai China"},{"name":"National Center for Neurological Disorders  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6024-3699","authenticated-orcid":false,"given":"Lichao","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Neurosurgical Intensive Care Unit, Huashan Hospital Fudan University  Shanghai China"},{"name":"Department of Neurosurgery, Huashan Hospital Fudan University  Shanghai China"},{"name":"National Center for Neurological Disorders  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7390-7303","authenticated-orcid":false,"given":"Haoyue","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgical Intensive Care Unit, Huashan Hospital Fudan University  Shanghai China"},{"name":"Department of Neurosurgery, Huashan Hospital Fudan University  Shanghai China"},{"name":"National Center for Neurological Disorders  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9811-6412","authenticated-orcid":false,"given":"Yu","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgical Intensive Care Unit, Huashan Hospital Fudan University  Shanghai China"},{"name":"Department of Neurosurgery, Huashan Hospital Fudan University  Shanghai China"},{"name":"National Center for Neurological Disorders  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6345-9067","authenticated-orcid":false,"given":"Jin","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgical Intensive Care Unit, Huashan Hospital Fudan University  Shanghai China"},{"name":"Department of Neurosurgery, Huashan Hospital Fudan University  Shanghai China"},{"name":"National Center for Neurological Disorders  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgical Intensive Care Unit, Huashan Hospital Fudan University  Shanghai China"},{"name":"Department of Neurosurgery, Huashan Hospital Fudan University  Shanghai China"},{"name":"National Center for Neurological Disorders  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,22]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-019-00750-3"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noae145"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-011-0764-0"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-021-02150-7"},{"issue":"2","key":"e_1_2_14_6_1","first-page":"44","article-title":"Post\u2010Operative Intensive Care Unit Admission for Elective Brain Tumour Surgeries: A Nigerian Neurosurgical Unit Experience","volume":"21","author":"Agboola O. 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