Hernandez Edrome F, Go Chris Jordan T, Collantes Ma Epifania V
Department of Internal Medicine, Manila Doctors Hospital, Manila, Philippines.
Department of Neurosciences, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
Acta Med Philipp. 2024 Aug 30;58(15):61-66. doi: 10.47895/amp.vi0.7456. eCollection 2024.
A growing body of evidence supports that inflammatory mechanisms are involved in secondary brain injury after intracerebral hemorrhage (ICH) which has implications on the morbidity and mortality of stroke patients. Neutrophil-to-lymphocyte ratio (NLR) is a comprehensive index marker of inflammation and immune status of a patient. The prognostic value of NLR in predicting in-hospital mortality and functional outcome of patients with spontaneous intracerebral hemorrhage will be assessed in this study.
We retrospectively selected 151 hemorrhagic stroke patients, and demographic and clinical characteristics were collected and computed for NLR. Receiver operating characteristic analysis using Youden's index was utilized to determine the NLR cut-off value with the best sensitivity and specificity. The association of NLR with the in-hospital mortality and functional outcome was assessed using Logistic regression analysis. Pearson Product Model Correlation was employed to evaluate the correlation of NLR with ICH volume.
Admission NLR >7 showed a significant association (p=<0.001 OR 7.99) with in-hospital mortality with a sensitivity of 70.83% and specificity of 72.82%. Furthermore, computed NLR of more than 6.4 showed significant association (p=0.040 OR 2.92) with poor functional outcome. However, our study revealed that admission NLR showed a low level of correlation (r=0.2968, p=0.002) with the volume of ICH.
This study demonstrated that ICH patients with an elevated NLR is associated with increased in-hospital mortality and poor functional outcome and that NLR can be used to predict clinical outcome among patients with spontaneous ICH.
越来越多的证据支持炎症机制参与脑出血（ICH）后的继发性脑损伤，这对中风患者的发病率和死亡率有影响。中性粒细胞与淋巴细胞比值（NLR）是患者炎症和免疫状态的综合指标标志物。本研究将评估NLR在预测自发性脑出血患者院内死亡率和功能结局方面的预后价值。
我们回顾性选择了151例出血性中风患者，收集了人口统计学和临床特征并计算NLR。使用约登指数进行受试者工作特征分析，以确定具有最佳敏感性和特异性的NLR临界值。使用逻辑回归分析评估NLR与院内死亡率和功能结局的关联。采用Pearson积矩相关模型评估NLR与ICH体积的相关性。
入院时NLR>7与院内死亡率显著相关（p=<0.001，OR 7.99），敏感性为70.83%，特异性为72.82%。此外，计算得出NLR大于6.4与功能结局不良显著相关（p=0.040，OR 2.92）。然而，我们的研究表明入院时NLR与ICH体积的相关性较低（r=0.2968，p=0.002）。
本研究表明，NLR升高的ICH患者与院内死亡率增加和功能结局不良相关，并且NLR可用于预测自发性ICH患者的临床结局。
