{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T05:01:55Z","timestamp":1790226115099,"version":"4.1.0"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Consciousness disturbance (CD) is a severe neurological manifestation of cerebral venous sinus thrombosis (CVST), but the association between the systemic immune-inflammation index (SII) and CD has not been fully characterised.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective single-centre cohort included 213 adults with imaging-confirmed CVST, of whom 55 (25.8%) had CD during the acute admission. We applied a four-step variable-selection procedure, a ten-seed LASSO-consensus approach, fixed-feature 3 \u00d7 10-fold repeated cross-validation, and full-pipeline nested internal validation as a sensitivity analysis. SII was evaluated continuously, by quartiles, and using restricted cubic splines, with additional confounding, component-comparison, interaction, calibration, and incremental-value analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the exploratory standardised three-predictor model, higher SII (OR 4.68, 95% bootstrap CI 2.98\u20138.64; P &amp;lt;0.001), intracerebral haemorrhage (OR per 1 SD 1.62, 1.14\u20132.40; P = 0.008), and lower platelet count (OR 0.39, 0.23\u20130.57; P &amp;lt;0.001) showed conditional associations with CD. Logistic regression using eight LASSO-consensus features achieved AUROC 0.840 \u00b1 0.092 with a train-test gap of 0.028 in the prespecified fixed-feature repeated cross-validation. A like-for-like fixed-feature logistic-regression comparison showed that the three-predictor model retained similar discrimination to the eight-feature model (mean per-fold AUROC 0.837 \u00b1 0.091 vs. 0.840 \u00b1 0.092) with a smaller train-test gap (0.004 vs. 0.028). The full-pipeline nested sensitivity analysis yielded AUROC 0.800 (95% CI 0.717\u20130.869). Patients in the highest SII quartile had 11.62-fold higher fully adjusted odds of CD than those in the lowest quartile (95% CI 2.82\u201347.87; P-trend = 0.0004). The spline supported an overall association (P &amp;lt;0.001) but not statistically significant nonlinearity (P = 0.151). In component sensitivity analyses, SII had greater unadjusted discrimination than neutrophil count, lymphocyte count, or platelet count (AUROC 0.783 vs. 0.638, 0.575, and 0.575, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher acute-phase SII was associated with CD in this cohort. The fixed-feature and full-pipeline nested analyses provide complementary internal evidence; prospective, temporally resolved, multicentre external validation is required before clinical use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1881634","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T04:39:33Z","timestamp":1790224773000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of the systemic immune-inflammation index with consciousness disturbance in cerebral venous sinus thrombosis: a retrospective cohort study"],"prefix":"10.3389","volume":"17","author":[{"given":"Xuhui","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Neurology, The Second Hospital of Lanzhou University","place":["Lanzhou, 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University","place":["Xining, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Liu","sequence":"additional","affiliation":[{"name":"Emergency Department, Qinghai Provincial People\u2019s Hospital","place":["Xining, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/s1474-4422(07)70029-7","article-title":"Cerebral venous thrombosis: an update","volume":"6","author":"Bousser","year":"2007","journal-title":"Lancet Neurol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.116.013617","article-title":"Cerebral venous sinus thrombosis incidence is higher than previously thought: A retrospective population-based study","volume":"47","author":"Devasagayam","year":"2016","journal-title":"Stroke"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1002\/rth2.12682","article-title":"Epidemiology 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