Predictive accuracy of neutrophil to lymphocyte ratio on long-term outcome in patients with spontaneous intracerebral hemorrhage.

Predictive accuracy of neutrophil to lymphocyte ratio on long-term outcome in patients with spontaneous intracerebral hemorrhage.

World Neurosurg. 2019 Feb 01;:

Authors: Zhang F, Ren Y, Fu W, Yang Z, Wen D, Hu X, Tao C, Li X, You C, Xin T, Yang M

Abstract
BACKGROUND: It is well established that inflammation plays critical roles in the progression of intracerebral hemorrhage (ICH). And recently neutrophil to lymphocyte ratio (NLR) was identified as a predictor for short-term outcome of ICH patients. However, the association of NLR on long-term outcome of patients with ICH remains unrevealed. Here, we aim to assess the relationship between NLR and long-term prognosis of ICH patients.
METHODS: All retrospectively enrolled cases of spontaneous ICH patients were hospitalized at West China Hospital of Sichuan University from October 2013 to May 2017. White blood count, absolute count of neutrophil and lymphocyte are extracted from electronic medical records, and NLR was calculated according to admission neutrophil count (ANC) and lymphocyte count (ALC). The associations between long-term outcomes and laboratory biomarkers were estimated by applying multivariable logistic regression analysis. The receiver operating characteristic curves (ROC) was also performed to compare the predictive power between each inflammatory factor.
RESULTS: A total of 481 ICH patients were included in current study. 204 of them presented with unfavorable outcomes, and 142 of them were dead within 6 months. Age, GCS scores, WBC, ANC, NLR, incidence of hematoma size and hydrocephalus were independently associated with poor prognosis of patients with ICH. By using multiple linear analyses, GCS, hematoma volume, WBC, ANC and ALC were correlated with NLR. Moreover, by comparing with other single laboratorial parameters, NLR also exhibited better predictive capacity for long-term mortality and morbidity, and the best predictive cutoff values are 9.07 and 8.69, respectively.
CONCLUSIONS: NLR independently predicts 180-days morbidity and 180-days mortality in patients with spontaneous ICH.

PMID: 30716500 [PubMed - as supplied by publisher]

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