Clinical Value of Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratio After Aneurysmal Subarachnoid Hemorrhage

Tao, Chuanmin; Wang, Jiajing; Hu, Xiuying; Ma, Junpeng; Li, Hao; You, Chao

doi:10.1007/s12028-016-0332-0

Cited by 121 publications

(96 citation statements)

References 39 publications

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“…Recently, in some ICH-studies, NLR has been associated with clinical endpoints [2,12,[16][17][18][19] . However, in ICH patients, little is known about the natural course of systemic inflammation during hospital stay and whether NLR is associated with short-term mortality.…”

Section: Neutrophil-to-lymphocyte Ratio Is Anmentioning

confidence: 99%

Neutrophil-to-Lymphocyte Ratio Is an Independent Predictor for In-Hospital Mortality in Spontaneous Intracerebral Hemorrhage

Giede-Jeppe¹,

Bobinger²,

Gerner³

et al. 2017

Cerebrovasc Dis

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Health Stroke Scale [NIHSS] 18 [9-32] vs. 10 [4-21]; p < 0.001), larger hematoma volume on admission (17.6 [6.9-47.7] vs. 10.6 [3.8-31.7] mL; p = 0.001), and more frequently unfavorable outcome 116/641; p < 0.001), and increased c-reactive-protein levels on admission ( p < 0.001; R 2 = 0.064). Adjusting for the abovementioned baseline confounders, multivariable logistic analyses revealed independent associations of NLROA with inhospital mortality (OR 0.967, 95% CI 0.939-0.997; p = 0.029). Conclusions: NLR represents an independent parameter associated with increased mortality in ICH patients. Stroke physicians should focus intensely on patients with increased NLR, KeywordsIntracerebral hemorrhage · Neutrophil-to-lymphocyte ratio · Inflammation · In-hospital mortality Abstract Background and Purpose: Stroke-associated immunosuppression and inflammation are increasingly recognized as factors that trigger infections and thus, potentially influence the outcome after stroke. Several studies demonstrated that elevated neutrophil-to-lymphocyte ratio (NLR) is a significant predictor of adverse outcomes in patients with ischemic stroke. However, little is known about the impact of NLR on short-term mortality in intracerebral hemorrhage (ICH). Methods: This observational study included 855 consecutive ICH-patients. Patient demographics, clinical, laboratory, and in-hospital measures as well as neuroradiological data were retrieved from institutional databases. Functional 3-monthsoutcome was assessed and categorized as favorable (modified Rankin Scale [mRS] 0-3) and unfavorable (mRS 4-6). We (i) studied the natural course of NLR in ICH, (ii) analyzed parameters associated with NLR on admission (NLROA), and (iii) evaluated the clinical impact of NLR on mortality and functional outcome. Results: The median NLROA of the entire cohort was 4.66 and it remained stable during the entire hospital stay. Patients with NLR ≥ 4.66 showed significant associations with poorer neurological status (National Institute of

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Section: Neutrophil-to-lymphocyte Ratio Is Anmentioning

confidence: 99%

Neutrophil-to-Lymphocyte Ratio Is an Independent Predictor for In-Hospital Mortality in Spontaneous Intracerebral Hemorrhage

Giede-Jeppe¹,

Bobinger²,

Gerner³

et al. 2017

Cerebrovasc Dis

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“…In a recent study NLR and PLR were found as independent predictors of delayed cerebral ischemia development and worse functional outcome after acute aneurysmal SAH (10). Taken together, all these results indicate that inflammation at least partially mediates the linkage between the short term mortality of SAH with lymphopenia, NLR and PLR.…”

Section: Discussionmentioning

confidence: 69%

“…NLR and PLR are novel composite inflammatory markers in the area of vascular pathologies including cerebral iscemia, intracerebral hemorrhage, venous thromboembolism (10,11,17). It has been also shown that increased platelet activation plays an important role in the initiation and progression of atherosclerosis.…”

Section: Discussionmentioning

confidence: 99%

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Admission Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratio as a predictor of mortality in patients with Subarachnoid Hemorrhage

Yılmaz¹,

Özkul²

2018

TÃ¼rk Beyin Damar Hast Derg

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INTRODUCTION: Inflammation is associated with the pathogenesis of subarachnoid hemorrhage (SAH) which is a serious disease with high mortality. NLR and PLR as novel inflammatory markers may serve as predictors of clinical severity and mortality in patients with SAH. METHODS: Medical records of adult SAH patients who were admitted to our Neurology and Neurosurgery Departments were investigated. Clinical, neuroradiological, laboratory, and follow-up data were collected from electronic database. Admission complete blood count values including hemoglobin, leukocyte, neutrophil, platelet and mean platelet volume, neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were also studied. Fisher score and mortality rates were also evaluated. RESULTS: A total of 152 patients with a mean age of 52.94±17.04 (20-104) years, (94 (%61.8) females and 58 (38.2%) males) with SAH were included in the study. The patients were divided into two groups: aneurysmal (group 1, n:99) and nonaneurysmal SAH (group 2, n:53). In comparison of complete blood count parameters we found lower lymphocyte and higher neutrophil, NLR and PLR values in aneurysmal SAH patients who had also higher Fisher scores and mortality rate. There were also correlations between Fisher score and leukocyte, neutrophil, lymphocyte, NLR and PLR values. We also found that advanced age and higher NLR, PLR values are significantly related to mortality rates independent of presence of aneurysm. DISCUSSION and CONCLUSION: Aneurysmal SAH patients had lower lymphocyte and higher neutrophil, NLR, PLR values with higher mortality rates and disease severity. Additionally advanced age and higher NLR, PLR values were significantly related to mortality rates independent of presence of aneurysm. We believe that NLR and PLR can be used as simple parameters to evaluate severity of SAH and short term mortality in clinical practice.

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“…Furthermore, Buck [9] demonstrated the higher NLR was associated with larger infarct volumes in patients with AIS, rather than lymphocyte counts. Recently, the platelet to lymphocyte ratio (PLR) was considered as a novel predictor for functional outcomes in patients with stroke [36,37]. Until now, there was one study [36] regarding the influence of PLR to ischemic stroke, with a sensitivity of 73% and specificity of 69%, however, this study had the limited number of patients without multivariate regression analysis.…”

Section: Figurementioning

confidence: 99%

The prediction of neutrophil to lymphocyte ratio for outcomes in ischemic stroke

Ye¹,

Ai²,

Fang³

et al. 2017

Oncotarget

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Objective: Neutrophil to lymphocyte ratio (NLR) is a prognostic inflammatory biomarker in patients with cardiovascular disease and hemorrhagic stroke. This metaanalysis aims to evaluate the prognostic values of NLR in predicting clinical outcomes in patients with ischemic stroke.Methods: A literature search was performed using the databases PubMed, EMBASE, Cochrane Central Register of Controlled Trials and China National Knowledge Infrastructure. Two reviewers independently retrieved papers that met the inclusion criteria. Subgroup analyses were performed using in-hospital mortality, 90-day mortality and 90-day poor outcomes (mRS>2) as the outcome measures.Results: Eight studies with 3855 patients were included in the analysis. An elevated NLR was a strong predictor for in-hospital mortality (OR: 1.05; 95% CI: 1.03-1.07, p<0.001) and for 90-day poor outcomes (OR: 2.28; 95% CI: 1.39-3.73, p<0.001), but not for 90-day mortality (OR: 3.04; 95% CI: 0.74-12.55, p=0.12). After performing subgroup analysis, the NLR was found to predict 90-day mortality with a high (>5) cut-off values (OR: 6.69; 95% CI: 1.70-26.33, p=0.007). The lower cut-off values had no significance (OR: 2.17; 95% CI: 0.43-10.86, p=0.35).Conclusions: A high NLR was significantly associated with higher rates of inhospital mortality and 90-day poor outcome in patients with ischemic stroke, especially with a high mean NLR or high cut-off values. With a high cut-off value (>5), NLR could predict the 90-day mortality after ischemic stroke.

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Clinical Value of Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratio After Aneurysmal Subarachnoid Hemorrhage

Abstract: NLR and PLR as novel inflammatory biomarkers are independent predictors of DCI development and functional outcome after acute aSAH. When combined together, they may help to identify high-risk patients more powerfully.

Cited by 121 publications

References 39 publications

Neutrophil-to-Lymphocyte Ratio Is an Independent Predictor for In-Hospital Mortality in Spontaneous Intracerebral Hemorrhage

Neutrophil-to-Lymphocyte Ratio Is an Independent Predictor for In-Hospital Mortality in Spontaneous Intracerebral Hemorrhage

Admission Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratio as a predictor of mortality in patients with Subarachnoid Hemorrhage

The prediction of neutrophil to lymphocyte ratio for outcomes in ischemic stroke

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