Shi Min, Yang Chao, Tang Qing-Wen, Xiao Ling-Fei, Chen Zu-Han, Zhao Wen-Yuan
Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China.
Department of Orthopaedics, Zhongnan Hospital of Wuhan University, Wuhan, China.
Front Neurol. 2021 Nov 15;12:745560. doi: 10.3389/fneur.2021.745560. eCollection 2021.
The neutrophil-to-lymphocyte ratio (NLR), as an essential systemic inflammation factor, has been widely used as a prognostic indicator in various diseases, such as malignant tumors, cardiovascular disease, and intracranial hemorrhage. An increasing number of studies have believed that NLR is a valuable predictor of prognosis for patients with aneurysmal subarachnoid hemorrhage (aSAH). However, these results remain controversial. In the current study, we planned to carry out a systematic review and meta-analysis to investigate the association between NLR and poor outcome, and the occurrence of delayed cerebral ischemia (DCI). We carried out a comprehensive search for published literatures on PubMed, EMBASE, Cochrane Library, and Web of Science databases from inception to April 1, 2021. We conducted an assessment of all included studies based on the principles proposed in the Newcastle-Ottawa Quality Assessment Scale (NOS). Poor outcome and the occurrence of DCI were considered as the main outcome measure. We calculated the pooled odds ratio (OR) and corresponding 95% confidence interval (CI) to examine the strength of the association of NLR with poor outcome or the occurrence of DCI. We strictly selected a total of 10 studies comprising 4,989 patients. Nine studies reported the association between NLR and poor outcome, and five studies reported the association between NLR and the occurrence of DCI. The pooled results indicated higher NLR was significantly associated with both poorer outcomes (OR = 1.32, 95%CI 1.11-1.57; = 0.002, = 87%), and the occurrence of DCI (OR = 1.72, 95%CI 1.22-2.41; = 0.002, = 82%) in aSAH patients. The NLR is a valuable indicator of inflammation to independently predict poor outcome and occurrence of DCI after aSAH, where a higher NLR is significantly associated with poor outcomes and occurrence of DCI. These findings suggest that the NLR can help clinicians evaluate the prognosis and identify potentially severe patients early, which may contribute to better management and improve poor prognosis of aSAH patients.
中性粒细胞与淋巴细胞比值（NLR）作为一种重要的全身炎症因子，已被广泛用作各种疾病（如恶性肿瘤、心血管疾病和颅内出血）的预后指标。越来越多的研究认为，NLR是动脉瘤性蛛网膜下腔出血（aSAH）患者预后的一个有价值的预测指标。然而，这些结果仍存在争议。在本研究中，我们计划进行一项系统评价和荟萃分析，以探讨NLR与不良预后以及迟发性脑缺血（DCI）发生之间的关联。我们对PubMed、EMBASE、Cochrane图书馆和Web of Science数据库从创建到2021年4月1日发表的文献进行了全面检索。我们根据纽卡斯尔-渥太华质量评估量表（NOS）提出的原则对所有纳入研究进行了评估。不良预后和DCI的发生被视为主要结局指标。我们计算了合并比值比（OR）和相应的95%置信区间（CI），以检验NLR与不良预后或DCI发生之间关联的强度。我们严格筛选了总共10项研究，包括4989例患者。9项研究报告了NLR与不良预后之间的关联，5项研究报告了NLR与DCI发生之间的关联。汇总结果表明，较高的NLR与aSAH患者较差的预后（OR = 1.32，95%CI 1.11 - 1.57；P = 0.002，I² = 87%）以及DCI的发生（OR = 1.72，95%CI 1.22 - 2.41；P = 0.002，I² = 82%）均显著相关。NLR是一种有价值的炎症指标，可独立预测aSAH后不良预后和DCI的发生，较高的NLR与不良预后和DCI的发生显著相关。这些发现表明，NLR可以帮助临床医生评估预后并早期识别潜在的重症患者，这可能有助于更好地管理并改善aSAH患者的不良预后。
