# # Key findings
- Overall survival: Elevated IINS was significantly associated with poorer overall survival across 11 analytic cohorts (HR 2.13, 95% CI 1.56–2.90, p < 0.001).
- Progression‑free survival: The score also correlated with worse progression‑free survival (p < 0.001).
- Graded risk: Higher IINS categories showed progressively less favorable outcomes.
# # Score composition
IINS integrates three readily available biomarkers:
- High‑sensitivity C‑reactive protein (CRP)
- Lymphocyte count
- Serum albumin
# # Limitations noted by authors
- Population: All 8 studies enrolled Chinese participants only; generalizability to other ethnicities is unknown.
- Design: Predominantly retrospective; only one prospective validation cohort was available.
- Comparison: No direct head‑to‑head analysis with established prognostic indices was performed.
- Interpretation: Binary high‑vs‑low and graded analyses were applied to different subsets of cohorts, complicating direct comparison.
# # Bottom line
While the meta‑analysis suggests IINS could serve as a useful prognostic tool, the authors emphasize that prospective, multicentre, multiethnic validation and direct comparison with existing scores are required before clinical adoption.