Early increase of neutrophil‐to‐lymphocyte ratio predicts 30‐day mortality in patients with spontaneous intracerebral hemorrhage

Abstract

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. Results: A total of 275 subjects were included in the analysis: 235 survived for at least 30 days; the remaining 40 subjects died within 30 days. The patients who died within 30 days had higher ICH score, larger ICH volume, and lower GCS score (all P < 0.05). In comparison with the baseline (NLR T1 ), NLR at 24-48 hours (NLR T2 ) and 5-7 days (NLR T3 ) was significantly higher in patients who died within 30 days (P < 0.05), but not in patients surviving for >30 days. In the multivariate analysis, the 30-day mortality was associated with both NLR T2 (OR 1.112, 95%CI 1.032-1.199, P = 0.006) and NLR T3 (OR 1.163, 95%CI 1.067-1.268, P = 0.001). Spearman correlation analysis showed that both NLR T2 and NLR T3 correlated inversely with GCS score and positively with ICH score and ICH volume at the baseline. Conclusions:Early rise of NLR predicts 30-day mortality in patients with spontaneous ICH.

Inhibition of activator protein 1 attenuates neuroinflammation and brain injury after experimental intracerebral hemorrhage

“…Concomitant with subsequent leukocyte infiltration, activated microglia augment the local production of proinflammatory cytokines, which amplifies blood–brain barrier (BBB) disruption and accelerates the expansion of perihematomal edema (PHE), resulting in more severe and durable brain injury . Although emerging evidence has implicated inflammation as a major component of PHE in the acceleration of brain injury following hemorrhage, the action of brain‐intrinsic factors in injury‐induced neuroinflammation remains poorly defined in ICH …”

Early elevated neutrophil‐to‐lymphocyte ratio associated with remote diffusion‐weighted imaging lesions in acute intracerebral hemorrhage

“…Therefore, the NLR is superior to the merely sum of leukocytes or neutrophils or lymphocytes in estimating individual inflammatory status. In patients with spontaneous ICH, elevated NLR has been closely related to the risk of mortality and 90‐day morbidity, and it also associated with stroke severity and peri‐hematoma edema growth . The recent remarkable observations indicated that NLR was an independent predictor for delayed cerebral ischemia in patients with a SAH, making it a prime candidate for assessing the inflammatory aspects of ICH.…”

“…Glasgow coma scale, median [IQR] 15 [14,15] 13 [10,13] .001** NIH stroke scale, median [IQR] 6 [3,10] 9 [4,13] .005** 90-day morbidity, 16,17 and it also associated with stroke severity and peri-hematoma edema growth. 15,32 The recent remarkable observations indicated that NLR was an independent predictor for delayed cerebral ischemia in patients with a SAH, 33 making it a prime candidate for assessing the inflammatory aspects of ICH.…”

“…It integrates neutrophils and lymphocytes and reflects the shift between them. In terms of ICH, NLR has been shown to be better than leukocytes alone for predicting peri‐hematoma edema growth and adverse clinical outcomes …”

“…In terms of ICH, NLR has been shown to be better than leukocytes alone for predicting peri-hematoma edema growth 15 and adverse clinical outcomes. 16,17 The primary aim of this study was to analyze the relationship between the circulating NLR and the R-DWILs in patients of ICH. Our findings showed that patients with an elevated NLR in acute stage should be intensely noted for the increased risk of R-DWILs.…”