Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Center for Evidence Based Medical and Clinical Research, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China.
BMC Neurol. 2023 Oct 19;23(1):374. doi: 10.1186/s12883-023-03433-x.
The prognosis of aneurysmal subarachnoid hemorrhage (aSAH) survivors is concerning. The goal of this study was to investigate and demonstrate the relationship between the neutrophil-to-albumin ratio (NAR) and long-term mortality of aSAH survivors.
A retrospective observational cohort study was conducted at Sichuan University West China Hospital between January 2009 and June 2019. The investigation of relationship between NAR and long-term mortality was conducted using univariable and multivariable Cox regression models. To demonstrate the predictive performance of different biomarkers over time, time-dependent receiver operating characteristic curve (ROC) analysis and decision curve analysis (DCA) were created.
In total, 3173 aSAH patients were included in this study. There was a strong and continuous relationship between NAR levels and long-term mortality (HR 3.23 95% CI 2.75-3.79, p < 0.001). After adjustment, the result was still significant (adjusted HR 1.78 95% CI 1.49-2.12). Compared with patients with the lowest quartile (< 0.15) of NAR levels, the risk of long-term mortality in the other groups was higher (0.15-0.20: adjusted HR 1.30 95% CI 0.97-1.73; 0.20-0.28: adjusted HR 1.37 95% CI 1.03-1.82; >0.28: adjusted HR 1.74 95% CI 1.30-2.32). Results in survivors were found to be still robust. Moreover, out of all the inflammatory markers studied, NAR demonstrated the highest correlation with long-term mortality.
A high level of NAR was associated with increased long-term mortality among patients with aSAH. NAR was a promising inflammatory marker for long-term mortality of aSAH.
动脉瘤性蛛网膜下腔出血（aSAH）幸存者的预后令人担忧。本研究旨在探讨和证明中性粒细胞与白蛋白比值（NAR）与 aSAH 幸存者长期死亡率之间的关系。
本研究为 2009 年 1 月至 2019 年 6 月在四川大学华西医院进行的回顾性观察性队列研究。使用单变量和多变量 Cox 回归模型研究 NAR 与长期死亡率之间的关系。为了展示不同生物标志物随时间的预测性能，创建了时间依赖性接受者操作特征曲线（ROC）分析和决策曲线分析（DCA）。
本研究共纳入 3173 例 aSAH 患者。NAR 水平与长期死亡率之间存在强烈且持续的关系（HR 3.23，95%CI 2.75-3.79，p<0.001）。调整后结果仍然显著（调整后的 HR 1.78，95%CI 1.49-2.12）。与 NAR 水平最低四分位数（<0.15）的患者相比，其他组的长期死亡风险更高（0.15-0.20：调整后的 HR 1.30，95%CI 0.97-1.73；0.20-0.28：调整后的 HR 1.37，95%CI 1.03-1.82；>0.28：调整后的 HR 1.74，95%CI 1.30-2.32）。在幸存者中得到的结果仍然稳健。此外，在所研究的所有炎症标志物中，NAR 与长期死亡率相关性最高。
NAR 水平升高与 aSAH 患者的长期死亡率增加相关。NAR 是预测 aSAH 患者长期死亡率的有前途的炎症标志物。
