Ray Suvarthi, Kumar Vijay, Biswas Ratnadeep, Ojha Vishnu S, Bhushan Divendu, Kirti Ravi, Kumar Sanjeev
Department of General Medicine, All India Institute of Medical Sciences, Patna, Patna, IND.
Department of Emergency Medicine, All India Institute of Medical Sciences, Patna, Patna, IND.
Cureus. 2024 Sep 13;16(9):e69350. doi: 10.7759/cureus.69350. eCollection 2024 Sep.
The neutrophil-to-lymphocyte ratio (NLR) signifies systemic inflammation, which may correlate with worse outcomes in intracerebral hemorrhage (ICH) patients. This study explored NLR as a prognostic marker of functional outcomes in ICH and compared it with the ICH score.
This cross-sectional study was conducted at a tertiary-care hospital in India. Blood was collected from patients with ICH to calculate NLR. Functional outcomes were evaluated using the modified Rankin Scale (mRS) at discharge and 90 days follow-up.
The area under receiver operating characteristic curve (AUROC) for NLR predicting poor mRS scores (3-6) at discharge was 0.695 (p = 0.109), and at follow-up, it was 0.729 (p < 0.001) with a cut-off of ≥7.2, sensitivity 68%, and specificity 72%. The AUROC for ICH score was 0.846 (p = 0.003) at discharge and 0.845 (p < 0.001) at follow-up. DeLong's test indicated the ICH score had significantly better predictive performance than NLR at follow-up (p = 0.018).
NLR is a potential prognostic marker for ICH outcomes, showing significant predictive value at 90 days follow-up. However, the ICH score remains a more reliable predictor. Integrating NLR into the ICH score may enhance its prognostic accuracy, but further validation in multicentric studies is needed.
中性粒细胞与淋巴细胞比值（NLR）代表全身炎症反应，这可能与脑出血（ICH）患者的不良预后相关。本研究探讨NLR作为ICH功能预后的预测指标，并将其与ICH评分进行比较。
本横断面研究在印度一家三级护理医院进行。收集ICH患者的血液以计算NLR。在出院时和随访90天时使用改良Rankin量表（mRS）评估功能预后。
NLR预测出院时mRS评分差（3 - 6分）的受试者工作特征曲线下面积（AUROC）为0.695（p = 0.109），随访时为0.729（p < 0.001），临界值≥7.2，敏感性68%，特异性72%。ICH评分在出院时的AUROC为0.846（p = 0.003），随访时为0.845（p < 0.001）。DeLong检验表明，随访时ICH评分的预测性能明显优于NLR（p = 0.018）。
NLR是ICH预后的潜在预测指标，在90天随访时显示出显著的预测价值。然而，ICH评分仍然是更可靠的预测指标。将NLR纳入ICH评分可能会提高其预后准确性，但需要在多中心研究中进一步验证。
