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CNS Neurosci Ther. 2019 Jan;25(1):30-35. doi: 10.1111/cns.12977. Epub 2018 May 16.

Early increase of neutrophil-to-lymphocyte ratio predicts 30-day mortality in patients with spontaneous intracerebral hemorrhage.

Author information

1
Department of Critical Care Medicine, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, China.
2
Emergency Department, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, China.
3
Juyuan New District Community Healthcare Center of Jiading District, Shanghai, China.
4
Department of Clinical Laboratory, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, China.
5
Jiading Town Community Healthcare Center of Jiading District, Shanghai, China.

Abstract

AIMS:

To examine whether early rise of neutrophil-to-lymphocyte ratio (NLR) after patient hospitalization correlates with 30-day mortality in patients with spontaneous intracerebral hemorrhage (ICH).

METHODS:

This retrospective study included all patients receiving treatment for spontaneous ICH between January 2015 and September 2016 at the Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences in Shanghai, China. NLR was determined at admission (T1), at 24-48 hours (T2) and 5-7 days (T3). NLR and clinicopathologic features were compared between those who survived for >30 days vs not. Multivariate regression was used to identify risk factors for 30-day mortality.

RESULTS:

A total of 275 subjects were included in the analysis: 235 survived for at least 30 days; the remaining 40 subjects died within 30 days. The patients who died within 30 days had higher ICH score, larger ICH volume, and lower GCS score (all P < 0.05). In comparison with the baseline (NLRT 1 ), NLR at 24-48 hours (NLRT 2 ) and 5-7 days (NLRT 3 ) was significantly higher in patients who died within 30 days (P < 0.05), but not in patients surviving for >30 days. In the multivariate analysis, the 30-day mortality was associated with both NLRT 2 (OR 1.112, 95%CI 1.032-1.199, P = 0.006) and NLRT 3 (OR 1.163, 95%CI 1.067-1.268, P = 0.001). Spearman correlation analysis showed that both NLRT 2 and NLRT 3 correlated inversely with GCS score and positively with ICH score and ICH volume at the baseline.

CONCLUSIONS:

Early rise of NLR predicts 30-day mortality in patients with spontaneous ICH.

KEYWORDS:

inflammation; mortality; neutrophil-to-lymphocyte ratio; spontaneous intracerebral hemorrhage

PMID:
29767470
DOI:
10.1111/cns.12977

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