Shi Jia, Liu Yu, Wei Li, Guan Wei, Xia Weimin
Department of Neurosurgery, The Third Affiliated Hospital of Soochow University, Changzhou, China.
Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China.
Front Neurol. 2023 Jan 10;13:1062692. doi: 10.3389/fneur.2022.1062692. eCollection 2022.
Spontaneous intracerebral hemorrhage (ICH) usually occurs in the basal ganglia and is highly lethal and disabling. The aim of this study was to evaluate the predictors of 30-day mortality in patients with severe spontaneous basal ganglia hemorrhage.
This retrospective study included patients with severe basal ganglia intracerebral hemorrhage treated in the Third Affiliated Hospital of Soochow University from 2012 to 2018. Demographic, clinical, laboratory and neuroradiological data were collected. The short-term prognosis was evaluated and divided into death within 30-days and survival over 30-days. We studied the factors affecting the prognosis of patients with severe intracerebral hemorrhage, analyzed the parameters related to neutrophil-to-lymphocyte (NLR) at admission, and evaluated the predictive effect of NLR on 30-day mortality.
A total of 105 patients was included in this retrospective study. The 30-day death group had a larger hematoma, a higher probability of ventricular hemorrhage, a higher ICH score and a lower Glasgow Coma Scale (GCS) score on admission. Meanwhile, the patients in the death group had higher White blood cells (WBC) counts, neutrophil counts, NLRs and C-reactive protein (CRP) levels. The risk factors for 30-day death were related to the ICH volume, GCS score, ICH score, WBC count, neutrophil count, NLR and CRP. The univariate receiver operating characteristic (ROC) curve of the risk factors showed that the NLR had the best prediction performance. Mathematical predictive models for ICH patients showed that the model with NLR had better prediction accuracy.
The NLR is expected to be a potential biomarker for predicting the prognosis of patients with severe basal ganglia hemorrhage.
自发性脑出血（ICH）通常发生在基底节区，具有很高的致死率和致残率。本研究的目的是评估重度自发性基底节区脑出血患者30天死亡率的预测因素。
这项回顾性研究纳入了2012年至2018年在苏州大学附属第三医院接受治疗的重度基底节区脑出血患者。收集了人口统计学、临床、实验室和神经放射学数据。评估短期预后并分为30天内死亡和存活超过30天。我们研究了影响重度脑出血患者预后的因素，分析了入院时与中性粒细胞与淋巴细胞比值（NLR）相关的参数，并评估了NLR对30天死亡率的预测作用。
本回顾性研究共纳入105例患者。30天死亡组血肿更大，脑室出血概率更高，入院时脑出血评分更高，格拉斯哥昏迷量表（GCS）评分更低。同时，死亡组患者白细胞（WBC）计数、中性粒细胞计数、NLR和C反应蛋白（CRP）水平更高。30天死亡的危险因素与脑出血体积、GCS评分、脑出血评分、WBC计数、中性粒细胞计数、NLR和CRP有关。危险因素的单变量受试者工作特征（ROC）曲线显示，NLR具有最佳预测性能。脑出血患者的数学预测模型显示，包含NLR的模型具有更好的预测准确性。
NLR有望成为预测重度基底节区脑出血患者预后的潜在生物标志物。
