Hou Yuyang, Li Hua, Yang Hongkuan, Chen Rudong, Yu Jiasheng
Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Neurol. 2022 Aug 16;13:916968. doi: 10.3389/fneur.2022.916968. eCollection 2022.
To explore the relationship between fibrinogen and neutrophil to lymphocyte ratio (F-NLR) score and functional outcomes after aneurysmal subarachnoid hemorrhage (aSAH).
A retrospective study was conducted that involved all consecutive patients with aSAH admitted to our institution from March 2018 to October 2021. Factors, such as demographics, comorbidities, clinical characteristics, neuroradiological data, and laboratory parameters, were collected from institutional databases. All patients achieved neurological assessment using the modified Rankin Scale (mRS) score 3 months after discharge to clarify the functional outcomes. The results were classified as favorable (mRS score 0-2) and unfavorable (mRS score 3-6). Univariate and multivariable analyses were performed to identify the relevant factors between inflammatory markers and functional outcomes after aSAH. Subsequently, a receiver operating characteristic (ROC) curve analysis was conducted to evaluate the predicting performance of variables. A propensity score match (PSM) was performed to correct imbalances in patients' baseline characteristics.
Finally, 256 patients with aSAH were included in the study cohort. A total of 94 (36.7%) patients had an unfavorable outcome. F-NLR scores were 0 [interquartile range (IQR) 0-1] and 1 (IQR 1-2) in patients with favorable and unfavorable outcomes, respectively ( < 0.001). After adjustment, the F-NLR score on admission remained significantly associated with unfavorable outcomes in patients with aSAH. In the multivariable analysis, the F-NLR score was regarded as an independent risk factor of unfavorable outcomes [odds ratio (OR) 3.113, 95% CI 1.755-5.523, < 0.001]. In ROC analysis, the optimal cutoff value of the F-NLR score was 0.5 points. Two cohorts (n = 86 in each group) obtained from PSM with low F-NLR scores (0 points) and high F-NLR scores (1-2 points) were used for analysis. A significantly higher unfavorable functional outcome rate was observed in patients with high F-NLR scores (33.7 vs. 9.3%, < 0.001). The area under the curve (AUC) values of F-NLR scores before and after PSM were 0.767 and 0.712, respectively.
Fibrinogen and neutrophil to lymphocyte ratio score was an independent risk parameter associated with unfavorable functional outcomes at 3 months after aSAH. A higher F-NLR score predicts the occurrence of poor functional outcomes.
探讨纤维蛋白原与中性粒细胞与淋巴细胞比值（F-NLR）评分与动脉瘤性蛛网膜下腔出血（aSAH）后功能结局之间的关系。
进行一项回顾性研究，纳入2018年3月至2021年10月期间我院收治的所有连续性aSAH患者。从机构数据库中收集人口统计学、合并症、临床特征、神经放射学数据和实验室参数等因素。所有患者在出院3个月后使用改良Rankin量表（mRS）评分进行神经功能评估，以明确功能结局。结果分为良好（mRS评分0-2）和不良（mRS评分3-6）。进行单因素和多因素分析，以确定aSAH后炎症标志物与功能结局之间的相关因素。随后，进行受试者工作特征（ROC）曲线分析，以评估变量的预测性能。进行倾向评分匹配（PSM）以纠正患者基线特征的不平衡。
最终，256例aSAH患者被纳入研究队列。共有94例（36.7%）患者预后不良。良好和不良结局患者的F-NLR评分分别为0[四分位间距（IQR）0-1]和1（IQR 1-2）（<0.001）。调整后，aSAH患者入院时的F-NLR评分仍与不良结局显著相关。在多因素分析中，F-NLR评分被视为不良结局的独立危险因素[比值比（OR）3.113，95%可信区间1.755-5.523，<0.001]。在ROC分析中，F-NLR评分的最佳截断值为0.5分。从PSM中获得的两组（每组n = 86），低F-NLR评分（0分）和高F-NLR评分（1-2分）用于分析。高F-NLR评分患者的不良功能结局发生率显著更高（33.7%对9.3%，<0.001）。PSM前后F-NLR评分的曲线下面积（AUC）值分别为0.767和0.712。
纤维蛋白原与中性粒细胞与淋巴细胞比值评分是aSAH后3个月与不良功能结局相关的独立风险参数。较高的F-NLR评分预示着不良功能结局的发生。
