Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing 100070, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing 100070, China.
J Clin Neurosci. 2023 Sep;115:108-113. doi: 10.1016/j.jocn.2023.07.019. Epub 2023 Aug 4.
This study aimed to identify the association between the platelet-to-white blood cell ratio (PWR) and outcomes in patients with aneurysmal subarachnoid hemorrhage (aSAH). Data for patients diagnosed with aSAH and admitted from January 2015 to December 2020 were retrospectively analyzed. Multivariate logistic regression analysis was performed to identify factors that correlated with unfavorable outcomes at 3 months. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut-off value for the PWR to discriminate favorable and unfavorable outcomes at 3 months. The patients were then divided into two groups based on this cut-off value. To reduce selection bias, propensity score matching (PSM) was performed to balance the baseline characteristics. In total, 800 patients were enrolled in this study. The multivariate logistic regression analysis showed that the PWR (odds ratio, 1.05; 95% confidence interval, 1.00-1.09; p = 0.034) at admission was independently associated with unfavorable 3-month outcomes. ROC curve analysis identified 15.69 as the best cut-off PWR value for predicting clinical outcomes. After PSM, patients with a PWR < 15.69 exhibited a higher incidence of postoperative pneumonia (POP) (37.2% vs. 25.6%, p = 0.011) and unfavorable 3-month outcomes (19.3% vs. 12.1%, p = 0.043). These findings suggest that patients with aSAH showing a PWR < 15.69 at admission have a higher probability of developing POP, which may be the main factor causing unfavorable outcomes at 3 months.
本研究旨在探讨血小板与白细胞比值（PWR）与颅内动脉瘤性蛛网膜下腔出血（aSAH）患者预后的相关性。回顾性分析了 2015 年 1 月至 2020 年 12 月期间诊断为 aSAH 并入院的患者数据。采用多变量逻辑回归分析确定与 3 个月不良结局相关的因素。采用受试者工作特征（ROC）曲线分析确定 PWR 区分 3 个月时良好和不良结局的最佳截断值。然后根据该截断值将患者分为两组。为了减少选择偏差，进行了倾向评分匹配（PSM）以平衡基线特征。共纳入 800 例患者。多变量逻辑回归分析显示，入院时的 PWR（优势比，1.05；95%置信区间，1.00-1.09；p=0.034）与 3 个月时的不良结局独立相关。ROC 曲线分析确定 15.69 为预测临床结局的最佳截断 PWR 值。PSM 后，PWR<15.69 的患者术后肺炎（POP）发生率（37.2% vs. 25.6%，p=0.011）和 3 个月时不良结局发生率（19.3% vs. 12.1%，p=0.043）较高。这些发现表明，入院时 PWR<15.69 的 aSAH 患者发生 POP 的可能性更高，这可能是导致 3 个月时不良结局的主要因素。
