Yaming Sun1, Shoujiang You2, Chongke Zhong3, Zhichao Huang2, Lifang Hu4, Xia Zhang2, Jijun Shi2, Yongjun Cao5, Chun-Feng Liu6. 1. Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China; Department of Neurology, Zhangjiagang Hospital of Traditional Chinese Medicine, Nanjing University of Chinese Medicine, Suzhou 215600, China. 2. Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China. 3. Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, 215123, China. 4. Institutes of Neuroscience, Soochow University, Suzhou 215123, China. 5. Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China; Institutes of Neuroscience, Soochow University, Suzhou 215123, China. Electronic address: yongjuncao@126.com. 6. Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China; Institutes of Neuroscience, Soochow University, Suzhou 215123, China. Electronic address: liuchunfeng@suda.edu.cn.
Abstract
BACKGROUND: Neutrophil to lymphocyte ratio (NLR) serves as a powerful inflammatory marker for predicting cardiovascular events. Here, we investigate whether admission NLR is associated with hematoma volume, stroke severity, and 3-month outcomes in patients with acute intracerebral hemorrhage (ICH). METHODS: 352 patients with acute ICH were prospectively identified in this study. Demographic characteristics, lifestyle risk factors, NIHSS score, hematoma volumes, and other clinical features were recorded for all participants. Patients was divided into quartiles based on the admission NLR levels (Q1: <2.78; Q2: 2.78-4.08; Q3: 4.08-7.85; Q4: ≥7.85). Multivariable linear regression models and logistic regression models were used to evaluate the association between NLR and hematoma volume, admission severity, or the outcomes after ICH. RESULTS: Median NIHSS scores for each quartile (Q1 to Q4) were 6.0, 6.0, 6.0, and 11.0 (P=.001), and median hematoma volumes were 9.5, 9.3, 9.1, and 15.0ml (P=.005), respectively. After adjusting the age, sex, and other potential risk factors, the patients in Q4 had higher NIHSS scores (P=.042) and larger hematoma volume (P=.014). After 3-month follow-up, 148 poor outcomes (mRS, 3-6) and 47 all-cause deaths were documented. There were more patients with poor outcomes in Q4 than Q1. However, compared with the patients in Q1, those in Q4 were not associated with poor outcomes (P-trend=0.379), and all-cause mortality (P-trend=0.843) after adjust for other risk factors. CONCLUSIONS: Higher admission NLR are associated with larger hematoma volume and more serious stroke, but not 3-month outcomes in patients with acute ICH.
BACKGROUND: Neutrophil to lymphocyte ratio (NLR) serves as a powerful inflammatory marker for predicting cardiovascular events. Here, we investigate whether admission NLR is associated with hematoma volume, stroke severity, and 3-month outcomes in patients with acute intracerebral hemorrhage (ICH). METHODS: 352 patients with acute ICH were prospectively identified in this study. Demographic characteristics, lifestyle risk factors, NIHSS score, hematoma volumes, and other clinical features were recorded for all participants. Patients was divided into quartiles based on the admission NLR levels (Q1: <2.78; Q2: 2.78-4.08; Q3: 4.08-7.85; Q4: ≥7.85). Multivariable linear regression models and logistic regression models were used to evaluate the association between NLR and hematoma volume, admission severity, or the outcomes after ICH. RESULTS: Median NIHSS scores for each quartile (Q1 to Q4) were 6.0, 6.0, 6.0, and 11.0 (P=.001), and median hematoma volumes were 9.5, 9.3, 9.1, and 15.0ml (P=.005), respectively. After adjusting the age, sex, and other potential risk factors, the patients in Q4 had higher NIHSS scores (P=.042) and larger hematoma volume (P=.014). After 3-month follow-up, 148 poor outcomes (mRS, 3-6) and 47 all-cause deaths were documented. There were more patients with poor outcomes in Q4 than Q1. However, compared with the patients in Q1, those in Q4 were not associated with poor outcomes (P-trend=0.379), and all-cause mortality (P-trend=0.843) after adjust for other risk factors. CONCLUSIONS: Higher admission NLR are associated with larger hematoma volume and more serious stroke, but not 3-month outcomes in patients with acute ICH.
Authors: Fan Zhang; Yanming Ren; Yan Shi; Wei Fu; Chuanyuan Tao; Xi Li; Mu Yang; Chao You; Tao Xin Journal: Medicine (Baltimore) Date: 2019-06 Impact factor: 1.817