Journal
NEUROPSYCHIATRIC DISEASE AND TREATMENT
Volume 18, Issue -, Pages 985-993Publisher
DOVE MEDICAL PRESS LTD
DOI: 10.2147/NDT.S358078
Keywords
neutrophil-to-lymphocyte ratio; functional outcome; spontaneous intracerebral hemorrhage
Categories
Funding
- National Key Research and Development Program of China [2018YFC1312200/2018YFC1312204]
- National Science and Technology Major Project [2017ZX09304018]
- Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences [2019-I2M-5-029]
- Beijing Natural Science Foundation [Z200016]
- Beijing Municipal Committee of Science and Technology [Z201100005620010]
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This study found that a significantly increased NLR may have an impact on the poor outcomes and functional disability of patients with spontaneous intracerebral hemorrhage (ICH), while a slightly elevated NLR may play a protective role.
Background: The neutrophil-to-lymphocyte ratio (NLR) is an index reflecting the overall inflammatory and stress status of patients with major diseases. Many studies associated the NLR with neurological deterioration and a poor prognosis in the spontaneous intracerebral hemorrhage (ICH). However, most previous studies did not further analyze NLR by stratification, and with a relatively small sample size. Besides, the outcome evaluation mostly focused on short-term prognosis or a single timepoint. Methods: Patients' basic characteristics and laboratory examination results, including the NLR were taken at baseline, and data from the 1-year follow-up, including the modified Rankin Scale (mRS) and survival status, was obtained for all patients. Patients included in the study were classified into four groups according to NLR quartiles (Q1-Q4). Logistic regression was used to analyze the relationship between different NLR levels and poor outcomes (mRS 3-5 and mRS 3-6). Results: A total of 594 ICH patients were enrolled. Glasgow Coma Scale (GCS), NIH Stroke Scale (NIHSS) and hematoma volume at first admission were significantly different between different NLR level groups (all P values <0.05). In the multivariate logistic regression model, at the 30-day follow-up, the Q4 (significantly increased NLR) group showed an elevated risk of poor outcomes (OR, 2.37; 95% CI, 1.17-4.83, P=0.02) and functional disability (OR, 2.21; 95% CI, 1.05-4.65, P=0.04). At the 3-month follow-up, the Q4 group still showed an elevated risk of poor outcomes (OR, 2.83; 95% CI, 1.38-5.77, P<0.01) and functional disability (OR, 2.77; 95% CI, 1.28-5.98, P<0.01). At the 1-year follow-up, the Q2 (slightly elevated NLR) group showed significant functional disability (OR, 0.34; 95% CI, 0.16-0.72, P<0.01). Conclusion: A significantly increased NLR may have an impact on the poor outcomes and functional disability of patients with ICH, while a slightly elevated NLR may play a protective role.
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