Improving the models for prognosis of aneurysmal subarachnoid hemorrhage with the neutrophil-to-albumin ratio

Zhang, Renjie; Liu, Zheran; Pei, Yiyan; He, Yan; Yu, Jiayi; You, Chao; Ma, Lu; Fang, Fang

doi:10.3389/fneur.2023.1078926

Cited by 3 publications

(2 citation statements)

References 38 publications

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“…However, the overburdened risk of mortality in patients with aSAH persists for much longer than one year, necessitating urgent studies on the prognosis of aSAH. Several studies have revealed the association between NAR and complications and 3-months poor outcomes [ 18 , 20 , 25 , 38 ]. In the absence of long-term follow-up, however, the predictive value of NAR for the long-term prognosis of aSAH was null.…”

Section: Discussionmentioning

confidence: 99%

Association between neutrophil-to-albumin ratio and long-term mortality of aneurysmal subarachnoid hemorrhage

Zhang,

Liu

et al. 2023

BMC Neurol

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Objective The prognosis of aneurysmal subarachnoid hemorrhage (aSAH) survivors is concerning. The goal of this study was to investigate and demonstrate the relationship between the neutrophil-to-albumin ratio (NAR) and long-term mortality of aSAH survivors. Methods A retrospective observational cohort study was conducted at Sichuan University West China Hospital between January 2009 and June 2019. The investigation of relationship between NAR and long-term mortality was conducted using univariable and multivariable Cox regression models. To demonstrate the predictive performance of different biomarkers over time, time-dependent receiver operating characteristic curve (ROC) analysis and decision curve analysis (DCA) were created. Results In total, 3173 aSAH patients were included in this study. There was a strong and continuous relationship between NAR levels and long-term mortality (HR 3.23 95% CI 2.75–3.79, p < 0.001). After adjustment, the result was still significant (adjusted HR 1.78 95% CI 1.49–2.12). Compared with patients with the lowest quartile (< 0.15) of NAR levels, the risk of long-term mortality in the other groups was higher (0.15–0.20: adjusted HR 1.30 95% CI 0.97–1.73; 0.20–0.28: adjusted HR 1.37 95% CI 1.03–1.82; >0.28: adjusted HR 1.74 95% CI 1.30–2.32). Results in survivors were found to be still robust. Moreover, out of all the inflammatory markers studied, NAR demonstrated the highest correlation with long-term mortality. Conclusions A high level of NAR was associated with increased long-term mortality among patients with aSAH. NAR was a promising inflammatory marker for long-term mortality of aSAH.

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Section: Discussionmentioning

confidence: 99%

Association between neutrophil-to-albumin ratio and long-term mortality of aneurysmal subarachnoid hemorrhage

Zhang,

Liu

et al. 2023

BMC Neurol

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“…Apart from individual inflammatory markers, comprehensive immune parameters may detect more subtle changes in peripheral blood associated with the prognoses of aSAH, which involve more extensive information and may compensate for the limitations of using a single blood indicator. In a retrospective cohort study spanning 10 years, Zhang et al ( 51 ) highlighted the importance of inflammatory indicators in predicting aSAH prognosis. Their results demonstrated that incorporating the neutrophil-to-albumin ratio into existing prediction models, such as SAFIRE ( 52 ) and SAHIT ( 53 ), significantly improved the ability to predict the 3-month mortality of aSAH patients.…”

Section: Application Of Peripheral Blood Biomarkers In Ruptured Intra...mentioning

confidence: 99%

Potential application of peripheral blood biomarkers in intracranial aneurysms

Wu,

Zhao,

Kang

et al. 2023

Front. Neurol.

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Intracranial aneurysm (IA) counts are increasing yearly, with a high mortality and disability after rupture. Current diagnosis and treatment rely on costly equipment, lacking effective indicators for progression prediction and specific drugs for treatment. Recently, peripheral blood biomarkers, as common clinical test samples, reflecting the immune and inflammatory state of the body in real-time, have shown promise in providing additional information for risk stratification and treatment in IA patients, which may improve their outcomes after aneurysm rupture through anti-inflammatory therapy. Therefore, this paper reviewed the progress of potential biomarkers of IAs, including inflammatory blood indicators, cytokines, and blood lipids, aiming to aid individual management and therapy of aneurysms in clinical practices.

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A nomogram model for predicting postoperative prognosis in patients with aneurysmal subarachnoid hemorrhage using preoperative biochemical indices

Sun,

Xue,

Wang

et al. 2024

BMC Neurol

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Objective The nutritional status and inflammatory responses of patients with aneurysmal subarachnoid hemorrhage (aSAH) play a vital prognostic role. We investigated the relationship between preoperative prognostic nutritional index (PNI)、neutrophil/albumin ratio (NAR)、platelet/albumin ratio (PAR) and other factors and the clinical prognosis of patients who underwent clipping for aSAH and its predictive model. Methods The clinical data of 212 patients with aSAH who underwent neurosurgery at Nanyang Central Hospital between 2018 and 2023 were retrospectively analyzed. Based on the Glasgow Outcome Scale (GOS) score at 6 months postoperatively, the patients were categorized into two groups: poor (GOSI-III) and good (GOSIV-V) prognosis groups. Multivariate logistic regression analysis was performed to determine the predictive value of preoperative PNI、NAR、PAR、hyperlipidemia and Glasgow Coma Scale (GCS) for prognosis. Furthermore, nomograms and prognostic prediction models were constructed. Receiver operating characteristic curves and area under the curve (AUC) were utilized to determine the predictive values. Results Multivariate logistic regression analysis revealed that PNI (OR = 1.250, 95%CI 1.060 ~ 1.475, P = 0.008), NAR (OR = 0.000, 95%CI 0.000 ~ 0.004, P = 0.000), PAR(OR = 0.515, 95%CI 0.283 ~ 0.937, P = 0.030), hyperlipidemia (OR = 4.627, 95%CI 1.166 ~ 18.367, P = 0.029), and GCS(OR = 1.446, 95%CI 1.041 ~ 2.008, P = 0.028) are independent risk factors for poor postoperative prognosis. The total score of the nomogram was 200, and the AUC value was 0.972. Conclusions PNI and NAR can reflect the nutritional status and inflammatory responses of patients.They are significantly associated with the postoperative prognosis of patients with aSAH. Comprehensively analyzing PNI and NAR combined with other clinical indicators can more effectively guide treatment and help predict prognosis.

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Improving the models for prognosis of aneurysmal subarachnoid hemorrhage with the neutrophil-to-albumin ratio

Cited by 3 publications

References 38 publications

Association between neutrophil-to-albumin ratio and long-term mortality of aneurysmal subarachnoid hemorrhage

Association between neutrophil-to-albumin ratio and long-term mortality of aneurysmal subarachnoid hemorrhage

Potential application of peripheral blood biomarkers in intracranial aneurysms

A nomogram model for predicting postoperative prognosis in patients with aneurysmal subarachnoid hemorrhage using preoperative biochemical indices

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