Admission neutrophil-to-lymphocyte ratio predicts length of hospitalization and need for ICU admission in adults with Status Epilepticus

Olivo, Sasha; Stella, Alex Buoite; Pavan, Stefania; Cegalin, Matteo; Furlanis, Giovanni; Cheli, Marta; Tomaselli, M.; Stokelj, David; Manganotti, Paolo

doi:10.1016/j.seizure.2023.02.001

Cited by 3 publications

(1 citation statement)

References 37 publications

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“…NLR has consistently performed well as a prognostic marker of various inflammation-related diseases, including epilepsy. However, novel markers such as SII have also demonstrated high predictive value (17)(18)(19). Status epilepticus, a special state of epilepsy, is associated with systemic inflammatory responses.…”

Section: Discussionmentioning

confidence: 99%

Correlation between inflammatory markers over time and disease severity in status epilepticus: a preliminary study

Shi,

Zhang,

Song

et al. 2024

Front. Neurol.

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ObjectivesConvulsive status epilepticus (CSE) is a major subtype of status epilepticus that is known to be closely associated with systemic inflammation. Some important inflammatory biomarkers of this disorder include the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune inflammation index (SII), and pan-immune inflammation value (PIV). This study aimed to determine the NLR, PLR, MLR, SII, and PIV levels before and after treatment in adult patients with CSE and investigated the relationship of these parameters with disease severity.MethodsThis retrospective study analyzed data from 103 adult patients with CSE and 103 healthy controls. The neutrophil, monocyte, platelet, and lymphocyte counts, as well as the NLR, PLR, MLR, SII, and PIV, were compared in adult patients with CSE during acute seizures (within 2 h of admission) and after treatment relief (1–2 weeks of complete seizure control). Furthermore, multivariate linear regression analysis investigated the relationship between NLR, PLR, MLR, SII, and PIV with the Status Epilepticus Severity Score (STESS).ResultsThe data revealed significant differences (p < 0.05) in neutrophils, monocytes, lymphocytes, NLR, PLR, MLR, SII, and PIV between adult patients with CSE during acute seizures and after treatment relief. The average neutrophil count was high during acute seizures in the patient group and decreased after remission. In contrast, the average lymphocyte count was lower after remission (p < 0.05). Furthermore, significant differences (p < 0.05) were observed in monocytes, lymphocytes, platelets, NLR, PLR, MLR, and PIV levels between adult patients with CSE after remission and the healthy control group. Multivariate linear regression analysis showed no significant correlation between NLR, PLR, MLR, SII, and PIV with STESS.ConclusionThe results of this study indicated that adult patients with CSE experienced a transient systemic inflammatory response during acute seizures, which gradually returned to baseline levels after remission. However, there was a lack of robust clinical evidence correlating the severity of adult CSE and systemic inflammatory response.

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Section: Discussionmentioning

confidence: 99%

Correlation between inflammatory markers over time and disease severity in status epilepticus: a preliminary study

Shi,

Zhang,

Song

et al. 2024

Front. Neurol.

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The role of neutrophil-to-lymphocyte ratio in predicting outcomes in patients with status epilepticus: Considerations beyond CBC

Golcuk

2023

Seizure: European Journal of Epilepsy

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Impact of frailty, biomarkers and basic biochemical parameters on outcomes of comatose patients in status epilepticus: a single-center prospective pilot study

Krejzar,

Sila,

Waldauf

et al. 2024

BMC Neurol

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Background Status epilepticus (SE) is a severe acute condition in neurocritical care with high mortality. Searching for risk factors affecting the prognosis in SE remains a significant issue. The primary study’s aim was to test the predictive values of the Clinical Frailty Scale (CFS) and the Modified 11-item Frailty Index (mFI-11), the biomarkers and basic biochemical parameters collected at ICU on the Glasgow Outcome Scale (GOS) assessed at hospital discharge (hosp), and three months later (3 M), in comatose patients with SE. The secondary aim was to focus on the association between the patient’s state at admission and the duration of mechanical ventilation, the ICU, and hospital stay. Methods In two years single-centre prospective pilot study enrolling 30 adult neurocritical care patients with SE classified as Convulsive SE, A.1 category according to the International League Against Epilepsy (ILAE) Task Force without an-/hypoxic encephalopathy, we evaluated predictive powers of CFS, mFI-11, admission Status Epilepticus Severity Score (STESS), serum protein S100, serum Troponin T and basic biochemical parameters on prognosticating GOS using univariate linear regression, logistic regression and Receiver Operating Characteristic (ROC) analysis. Results Our study included 60% males, with a mean age of 57 ± 16 years (44–68) and a mean BMI of 27 ± 5.6. We found CFS, mFI-11, STESS, and age statistically associated with GOS at hospital discharge and three months later. Among the biomarkers, serum troponin T level affected GOS hosp (p = 0.027). Serum C-reactive protein significance in prognosticating GOS was found by logistic regression (hosp p = 0.008; 3 M p = 0.004), and serum calcium by linear regression (hosp p = 0.028; 3 M p = 0.015). In relation to secondary outcomes, we found associations between the length of hospital stay and each of the following: age (p = 0.03), STESS (p = 0.009), and serum troponin T (p = 0.029) parameters. Conclusions This pilot study found promising predictive powers of two frailty scores, namely CFS and mFI-11, which were comparable to age and STESS predictors regarding the GOS at hospital discharge and three months later in ICU patients with SE. Among biomarkers and biochemical parameters, only serum troponin T level affected GOS at hospital discharge.

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Admission neutrophil-to-lymphocyte ratio predicts length of hospitalization and need for ICU admission in adults with Status Epilepticus

Cited by 3 publications

References 37 publications

Correlation between inflammatory markers over time and disease severity in status epilepticus: a preliminary study

Correlation between inflammatory markers over time and disease severity in status epilepticus: a preliminary study

The role of neutrophil-to-lymphocyte ratio in predicting outcomes in patients with status epilepticus: Considerations beyond CBC

Impact of frailty, biomarkers and basic biochemical parameters on outcomes of comatose patients in status epilepticus: a single-center prospective pilot study

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