The trend of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in spontaneous intracerebral hemorrhage and the predictive value of short-term postoperative prognosis in patients

Zhang, Jian; Liu, Chunlong; Hu, Yaofeng; Yang, Aoran; Zhang, Yonghui; Yang, Hong

doi:10.3389/fneur.2023.1189898

Cited by 3 publications

(2 citation statements)

References 43 publications

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“…Several previous studies have demonstrated the association of NLR with unfavorable functional outcomes in AIS (Chen et al, 2020), acute intracerebral ICH (Zhang et al, 2023), and subarachnoid hemorrhage (Oliveira & Rabelo, 2023). It has been reported that high neutrophil counts have been found at various stages of atherosclerosis, which could damage endothelial cells (Feng et al, 2023).…”

Section: Disscusionmentioning

confidence: 98%

Dynamic change of neutrophil‐to‐lymphocyte ratio and its predictive value of prognosis in acute ischemic stroke

Qian,

Hu,

Wang

et al. 2024

Brain and Behavior

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ObjectiveThe present research aimed to explore the dynamic change of the neutrophil‐to‐lymphocyte ratio (NLR) and its relationship with functional outcome following an acute ischemic stroke (AIS), whether receiving intravenous thrombolysis (IVT) or not.MethodsWe retrospectively analyzed data that were prospectively acquired from patients with AIS treated with IVT or not. For patients receiving IVT, the NLR was based on a blood test performed prior to IVT (d0) and at different time points after disease onset (d1, d3, d7). In addition, in the non‐IVT group, the NLR was obtained at different time points after disease onset (d1, d3, d7). Follow‐ups were performed 3 months after onset via telephone. In addition, a good outcome was defined as a modified Rankin scale (mRS) ≤1; a poor outcome means 2 ≤ mRS ≤ 6.ResultsA total of 204 AIS patients were included in this study. The NLR presented a dynamic change as it increased to its peak at day 1 and gradually declined to its baseline at day 7, no matter whether patients were receiving IVT or not. Patients with poor outcomes have a higher NLR at various time points. The results of multivariate logistic regression analysis demonstrated that the National Institutes of Health Stroke Scale (NIHSS), NLR d1, NLR d3, and NLR d7 were independently associated with functional outcomes. The area under the receiver operating characteristic curve of NLR in predicting outcomes was as follows: NLR d3 demonstrated robust predictive power within the IVT therapy cohort, whereas NLR d7 was predictive in the non‐IVT cohort. However, the most potent predictor emerged as the combination of NIHSS and NLR.ConclusionNLR has the potential to predicate diagnosis for AIS, especially when combined with the NIHSS score.

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Section: Disscusionmentioning

confidence: 98%

Dynamic change of neutrophil‐to‐lymphocyte ratio and its predictive value of prognosis in acute ischemic stroke

Qian,

Hu,

Wang

et al. 2024

Brain and Behavior

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“…Intracerebral hemorrhage (ICH), a prevalent acute central nervous system (CNS) disease, is noted for its high mortality and morbidity rates [1,2]. It accounts for roughly 15% of all stroke forms [3,4]. Merely 20% of ICH patients retain functional independence six months after the ICH impairment [5].…”

Section: Introductionmentioning

confidence: 99%

Activating transcription factor 6 alleviates secondary brain injury by increasing cystathionine γ-lyase expression in a rat model of intracerebral hemorrhage

Liang,

Xu,

Liu

et al. 2024

Aging

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Background: Intracerebral hemorrhage (ICH) comprises primary and secondary injuries, the latter of which induces increased inflammation and apoptosis and is more severe. Activating transcription factor 6 (ATF6) is a type-II transmembrane protein in the endoplasmic reticulum (ER). ATF6 target genes could improve ER homeostasis, which contributes to cryoprotection. Hence, we predict that ATF6 will have a protective effect on brain tissue after ICH. Method: The ICH rat model was generated through autologous blood injection into the right basal ganglia, the expression of ATF6 after ICH was determined by WB and IF. The expression of ATF6 was effectively controlled by means of intervention, and a series of measures was used to detect cell death, neuroinflammation, brain edema, blood-brain barrier and other indicators after ICH. Finally, the effects on long-term neural function of rats were measured by behavioral means. Result: ATF6 was significantly increased in the ICH-induced brain tissues. Further, ATF6 was found to modulate the expression of cystathionine γ-lyase (CTH) after ICH. Upregulation of ATF6 attenuated neuronal apoptosis and inflammation in ICH rats, along with mitigation of ICH-induced brain edema, blood-brain barrier deterioration, and cognitive behavior defects. Conversely, ATF6 genetic knockdown induced effects counter to those aforementioned. Conclusions: This study thereby emphasizes the crucial role of ATF6 in secondary brain injury in response to ICH, indicating that ATF6 upregulation may potentially ameliorate ICH-induced secondary brain injury. Consequently, ATF6 could serve as a promising therapeutic target to alleviate clinical ICH-induced secondary brain injuries.

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Neutrophil-to-lymphocyte ratio, white blood cell, and C-reactive protein predicts poor outcome and increased mortality in intracerebral hemorrhage patients: a meta-analysis

Guo,

Zou

2024

Front. Neurol.

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ObjectiveInflammation participates in the pathology and progression of secondary brain injury after intracerebral hemorrhage (ICH). This meta-analysis intended to explore the prognostic role of inflammatory indexes, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), white blood cell (WBC), and C-reactive protein (CRP) in ICH patients.MethodsEmbase, PubMed, Web of Science, and Cochrane Library were searched until June 2023. Two outcomes, including poor outcome and mortality were extracted and measured. Odds ratio (OR) and 95% confidence interval (CI) were presented for outcome assessment.ResultsForty-six studies with 25,928 patients were included in this meta-analysis. The high level of NLR [OR (95% CI): 1.20 (1.13–1.27), p < 0.001], WBC [OR (95% CI): 1.11 (1.02–1.21), p = 0.013], and CRP [OR (95% CI): 1.29 (1.08–1.54), p = 0.005] were related to poor outcome in ICH patients. Additionally, the high level of NLR [OR (95% CI): 1.06 (1.02–1.10), p = 0.001], WBC [OR (95% CI): 1.39 (1.16–1.66), p < 0.001], and CRP [OR (95% CI): 1.02 (1.01–1.04), p = 0.009] were correlated with increased mortality in ICH patients. Nevertheless, PLR was not associated with poor outcome [OR (95% CI): 1.00 (0.99–1.01), p = 0.749] or mortality [OR (95% CI): 1.00 (0.99–1.01), p = 0.750] in ICH patients. The total score of risk of bias assessed by Newcastle-Ottawa Scale criteria ranged from 7–9, which indicated the low risk of bias in the included studies. Publication bias was low, and stability assessed by sensitivity analysis was good.ConclusionThis meta-analysis summarizes that the high level of NLR, WBC, and CRP estimates poor outcome and higher mortality in ICH patients.

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The trend of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in spontaneous intracerebral hemorrhage and the predictive value of short-term postoperative prognosis in patients

Cited by 3 publications

References 43 publications

Dynamic change of neutrophil‐to‐lymphocyte ratio and its predictive value of prognosis in acute ischemic stroke

Dynamic change of neutrophil‐to‐lymphocyte ratio and its predictive value of prognosis in acute ischemic stroke

Activating transcription factor 6 alleviates secondary brain injury by increasing cystathionine γ-lyase expression in a rat model of intracerebral hemorrhage

Neutrophil-to-lymphocyte ratio, white blood cell, and C-reactive protein predicts poor outcome and increased mortality in intracerebral hemorrhage patients: a meta-analysis

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