Wang Haoxiang, Li Yuanyou, Ye Feng, Deng Ziang, Huang Keru, Li Gaowei, Chen Yaxing, Liu Yi, Zhou Liangxue
Department of Neurosurgery, West China Medical School, West China Hospital, Sichuan University, Chengdu, China.
Department of Pediatric Neurosurgery, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
BMC Neurol. 2025 Mar 19;25(1):115. doi: 10.1186/s12883-025-04137-0.
Hemorrhagic stroke has a high mortality and disability rate. Among them, intraventricular hemorrhage (IVH) is an important factor leading to adverse outcomes. IVH can induce acute obstructive hydrocephalus and chronic communicating hydrocephalus. However, there are currently no effective predictive factors for the early prediction of post-hemorrhage hydrocephalus (PHH).
To assess the role of inflammatory indicators in predicting PHH and poor prognostic outcomes in patients with ventricular hemorrhage.
Single center retrospective case-control study.
We retrospectively examined IVH patients treated at our institution from April 2017 to March 2022. Patient characteristics, laboratory data, imaging findings, and 3-month follow-up results were recorded and analyzed.
Among the 145 patients included in the analysis, 102 eventually developed adverse outcomes. There were significant differences between patients with good and poor prognosis in terms of age at admission, GCS score, prevalence of hypertension, lymphocyte count, albumin level, red blood cell distribution width, neutrophil count, NLR, PLR, NAR, PIV, and SII; in addition, among the 110 surviving patients, 36 eventually developed posthemorrhagic hydrocephalus within 3 months. Multivariate logistic regression showed that age and NAR are independent predictors of poor prognosis in IVH patients, while albumin is an independent predictor of posthemorrhagic hydrocephalus within 3 months.
The NLR and NAR are independent risk factors for poor prognosis in IVH patients. Additionally, albumin is an independent predictor of chronic hydrocephalus development within 3 months in IVH patients. The NLR, NAR and albumin level could provide prognostic information about IVH patients.
出血性卒中具有较高的死亡率和致残率。其中,脑室内出血(IVH)是导致不良结局的重要因素。IVH可诱发急性梗阻性脑积水和慢性交通性脑积水。然而,目前尚无有效的预测因素可用于早期预测出血后脑积水(PHH)。
评估炎症指标在预测脑室出血患者PHH及不良预后中的作用。
单中心回顾性病例对照研究。
我们回顾性研究了2017年4月至2022年3月在本机构接受治疗的IVH患者。记录并分析患者的特征、实验室数据、影像学表现及3个月的随访结果。
纳入分析的145例患者中,102例最终出现不良结局。预后良好和预后不良的患者在入院年龄、格拉斯哥昏迷量表(GCS)评分、高血压患病率、淋巴细胞计数、白蛋白水平、红细胞分布宽度、中性粒细胞计数、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、中性粒细胞与白蛋白比值(NAR)、血浆凝血酶原时间国际标准化比值(PIV)和全身炎症反应指数(SII)方面存在显著差异;此外,在110例存活患者中,36例最终在3个月内发生出血后脑积水。多因素logistic回归显示,年龄和NAR是IVH患者预后不良的独立预测因素,而白蛋白是IVH患者3个月内出血后脑积水的独立预测因素。
NLR和NAR是IVH患者预后不良的独立危险因素。此外,白蛋白是IVH患者3个月内慢性脑积水发生的独立预测因素。NLR、NAR和白蛋白水平可为IVH患者提供预后信息。