{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T12:15:38Z","timestamp":1783426538707,"version":"3.54.6"},"reference-count":24,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Objective: Malignant middle cerebral artery infarction is associated with high mortality despite decompressive craniectomy. Reliable biomarkers predicting early outcome remain limited. The aim of this study was to evaluate the prognostic significance of inflammatory biomarkers, particularly the systemic immune\u2013inflammation index (SII), for predicting in-hospital mortality in patients undergoing decompressive craniectomy for malignant middle cerebral artery infarction. Methods: This retrospective study included 31 patients who underwent decompressive craniectomy for malignant MCA infarction between 2014 and 2024. Demographic, clinical, radiological, and laboratory variables were analyzed. Results: Overall in-hospital mortality was 61.3%. Non-survivors had significantly higher SII, neutrophil count, neutrophil-to-lymphocyte ratio, serum creatinine, and higher prevalence of hypertension and anticoagulant therapy. ROC analysis showed that SII had the highest predictive performance (AUC = 0.833). Multivariate analysis identified age, serum creatinine, NLR, SII, hypertension, and anticoagulant therapy as independent predictors of mortality. Patients aged \u226565 years had significantly higher in-hospital mortality than younger patients. Conclusions: Elevated SII is a strong independent predictor of early mortality after decompressive craniectomy and may serve as a simple and clinically applicable biomarker for risk stratification.<\/jats:p>","DOI":"10.3390\/brainsci16070666","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T10:04:47Z","timestamp":1783418687000},"page":"666","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic Value of Systemic Immune-Inflammation Index for Early Mortality After Decompressive Craniectomy in Malignant Middle Cerebral Artery Infarction"],"prefix":"10.3390","volume":"16","author":[{"given":"Yasin","family":"Ta\u015fk\u0131n","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Tokat Gaziosmanpa\u015fa University, 60030 Tokat, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6zg\u00fcr","family":"Demir","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tokat Gaziosmanpa\u015fa University, 60030 Tokat, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veysel","family":"K\u0131yak","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tokat Gaziosmanpa\u015fa University, 60030 Tokat, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Arslan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Gaziantep City Hospital, 27470 Gaziantep, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6vg\u00fc Can","family":"\u00dcnal","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tokat Gaziosmanpa\u015fa University, 60030 Tokat, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunus Emre","family":"Kuyucu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Faculty of Medicine, Tokat Gaziosmanpa\u015fa University, 60030 Tokat, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1001\/archneur.1996.00550040037012","article-title":"Malignant middle cerebral artery territory infarction: Clinical course and prognostic signs","volume":"53","author":"Hacke","year":"1996","journal-title":"Arch. 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