Zhao Yiqin, Xie Yanfeng, Li Shengjie, Hu Mingliang
The First Clinical Medical School, Chongqing Medical University, Chongqing, China.
Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Front Neurol. 2022 Aug 22;13:963397. doi: 10.3389/fneur.2022.963397. eCollection 2022.
The purpose of this study was to explore the predictive value of the neutrophil-to-lymphocyte ratio (NLR) on 30-day outcomes in patients with spontaneous intracerebral hemorrhage (ICH) after surgical treatment.
This retrospective study utilized data from patients with ICH who underwent craniotomy or minimally invasive puncture and drainage (MIPD) between January 2015 and June 2021. The patients meeting the inclusion criteria were divided into two groups according to 30-day outcomes, namely, the favorable outcome group and the poor outcome group. Sex, age, time from onset to admission, vital signs at admission, admission Glasgow Coma Scale (GCS) score, diabetes mellitus, hypertension, hematoma volume, hematoma location, surgical approach, and NLR at different time points were all recorded and analyzed.
A total of 128 patients were finally enrolled in this study, including 32 and 96 patients in the favorable outcome group and the poor outcome group, respectively. During the course of ICH, the changing trend of NLR was to increase first and then decrease and peaked within 48 h after surgery. In the univariate analysis, systolic blood pressure, admission GCS score, hematoma volume, surgical approach, and NLR within 48 h after surgery were statistically significant. In the multivariable analysis, NLR within 48 h after surgery (odds ratio [] = 1.342, < 0.001) was an independent risk factor of the 30-day outcomes in patients with ICH after surgical treatment. The receiver operating characteristic (ROC) analysis showed that the best predictive cut-off value for NLR within 48 h after surgery was 12.35 [sensitivity 82.9%, specificity 81.8%, and area under the curve (AUC) 0.877] and 14.46 (sensitivity 55.1%, specificity 87.5%, and area under the curve 0.731) for the MIPD group and the craniotomy group, respectively.
In the process of ICH, the value of NLR was increased first and then decreased and peaked within 48 h after surgery. NLR within 48 h after surgery was an independent risk factor of the 30-day outcomes in patients with ICH. The peak NLR >12.35 or 14.46 in patients receiving MIPD or craniotomy reflected a poor prognosis, respectively.
本研究旨在探讨中性粒细胞与淋巴细胞比值（NLR）对自发性脑出血（ICH）患者手术治疗后30天预后的预测价值。
这项回顾性研究利用了2015年1月至2021年6月期间接受开颅手术或微创穿刺引流（MIPD）的ICH患者的数据。符合纳入标准的患者根据30天预后分为两组，即预后良好组和预后不良组。记录并分析性别、年龄、发病至入院时间、入院时生命体征、入院格拉斯哥昏迷量表（GCS）评分、糖尿病、高血压、血肿体积、血肿位置、手术方式以及不同时间点的NLR。
本研究最终纳入128例患者，其中预后良好组32例，预后不良组96例。在ICH病程中，NLR的变化趋势是先升高后降低，并在术后48小时内达到峰值。单因素分析中，收缩压、入院GCS评分、血肿体积、手术方式以及术后48小时内的NLR具有统计学意义。多因素分析中，术后48小时内的NLR（比值比[] = 1.342，<0.001）是ICH患者手术治疗后30天预后的独立危险因素。受试者工作特征（ROC）分析显示，术后48小时内NLR的最佳预测临界值，MIPD组为12.35[灵敏度82.9%，特异度81.8%，曲线下面积（AUC）0.877]，开颅手术组为14.46（灵敏度55.1%，特异度87.5%，曲线下面积0.731）。
在ICH病程中，NLR值先升高后降低，并在术后48小时内达到峰值。术后48小时内的NLR是ICH患者30天预后的独立危险因素。接受MIPD或开颅手术的患者，NLR峰值>12.35或14.46分别反映预后不良。
