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. 2017 Aug 10;8(52):90380-90389.
doi: 10.18632/oncotarget.20120. eCollection 2017 Oct 27.

The use of neutrophil to lymphocyte ratio as a predictor for clinical outcomes in spontaneous intracerebral hemorrhage

Zengpanpan Ye #  1 , Xiaolin Ai #  1 , Fang Fang #  1 , Xin Hu  1 , Andrew Faramand  2 , Chao You  1
Affiliations

The use of neutrophil to lymphocyte ratio as a predictor for clinical outcomes in spontaneous intracerebral hemorrhage

Zengpanpan Ye et al. Oncotarget. .

Abstract

Objective: Neutrophil to lymphocyte ratio (NLR) is used as an independent predictor for clinical outcomes in cancers, cardiovascular disorders and ischemic stroke. The prognostic role of NLR in spontaneous intracerebral hemorrhage (sICH) is still controversial. The aim of this report is to conduct a meta-analysis to evaluate the prognostic significance NLR in patients with sICH.

Materials and methods: All related articles were searched on PubMed, EMBASE, Cochrane Central Register of Controlled Trials followed the PRISMA flow diagram. The quality of eligible studies were evaluated and the related data were extracted by two reviewers independently. The end points included the mortality and poor outcomes and subgroup analyses were performed.

Results: Five studies with 1944 subjects were included and had acceptable quality. The high NLR had a higher risk of in-hospital mortality (OR: 0.97; 95% CI: 0.94-0.99, p = 0.02) and 90-day mortality (OR: 2.43; 95% CI: 1.01-5.83, p = 0.047); without association with the poor outcomes (OR: 1.17; 95% CI: 0.93-1.47, p = 0.18). After subgroup analyses, the high NLR correlated with an increased 90-day mortality in the high cut-off group (OR: 1.56; 95% CI: 1.15-2.13, p = 0.005). The high NLR additionally predicts poor outcomes in smaller hematoma group (OR: 1.16; 95% CI: 1.01-1.32, p = 0.04) and the high cut-off group (OR: 2.20; 95% CI: 1.54-3.14, p < 0.001).

Conclusions: The high NLR was significantly associated with in-hospital and 90-day mortality in patients with sICH. The NLR with cut-off of 7.5 had statistically significant potential for predicting mortality and poor outcomes, regardless of country, time of laboratory test and hematoma volumes.

Keywords: intracerebral hemorrhage; meta-analysis; neutrophil to lymphocyte ratio.

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Conflict of interest statement

CONFLICTS OF INTEREST No conflicts of interest.

Figures

Figure 1
Figure 1. The flow diagram of procedure to search the eligible studies
Figure 2
Figure 2. Forest plots for association of NLR and in-hospital mortality
Figure 3
Figure 3. Forest plots for association of NLR and 90-day mortality
Figure 4
Figure 4. Forest plots for association of NLR and poor outcomes
Figure 5
Figure 5. The Begg publication bias plot of the studies reported 90-day poor outcomes, and no publication bias was found in these studies with P = 0.734
Figure 6
Figure 6. The sensitivity analysis of the studies reported 90-day poor outcomes and the outcomes had no significant change after excluding a single study
See this image and copyright information in PMC

References

    1. Hemphill JC, 3rd, Greenberg SM, Anderson CS, Becker K, Bendok BR, Cushman M, Fung GL, Goldstein JN, Macdonald RL, Mitchell PH, Scott PA, Selim MH, Woo D, et al. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2015;46:2032–60. https://doi.org/10.1161/STR.0000000000000069. - DOI - PubMed
    1. van Asch CJ, Luitse MJ, Rinkel GJ, van der Tweel I, Algra A, Klijn CJ. Incidence, case fatality, and functional outcome of intracerebral hemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis. Lancet Neurol. 2010;9:167–76. https://doi.org/10.1016/S1474-4422(09)70340-0. - DOI - PubMed
    1. Mayer SA, Rincon F. Treatment of intracerebral hemorrhage. Lancet Neurol. 2005;4:662–72. https://doi.org/10.1016/S1474-4422(05)70195-2. - DOI - PubMed
    1. Aronowski J, Zhao X. Molecular pathophysiology of cerebral hemorrhage: secondary brain injury. Stroke. 2011;42:1781–6. https://doi.org/10.1161/STROKEAHA.110.596718. - DOI - PMC - PubMed
    1. Wang J. Preclinical and clinical research on inflammation after intracerebral hemorrhage. Prog Neurobiol. 2010;92:463–77. https://doi.org/10.1016/j.pneurobio.2010.08.001. - DOI - PMC - PubMed

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