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. 2024 Aug 30;58(15):61-66.
doi: 10.47895/amp.vi0.7456. eCollection 2024.

Admission Neutrophil-to-Lymphocyte Ratio as a Predictive Factor in the Outcome of Acute Spontaneous Intracerebral Hemorrhage

Edrome F Hernandez  1 , Chris Jordan T Go  1 , Ma Epifania V Collantes  1   2
Affiliations

Admission Neutrophil-to-Lymphocyte Ratio as a Predictive Factor in the Outcome of Acute Spontaneous Intracerebral Hemorrhage

Edrome F Hernandez et al. Acta Med Philipp. .

Abstract

Background and objective: A growing body of evidence supports that inflammatory mechanisms are involved in secondary brain injury after intracerebral hemorrhage (ICH) which has implications on the morbidity and mortality of stroke patients. Neutrophil-to-lymphocyte ratio (NLR) is a comprehensive index marker of inflammation and immune status of a patient. The prognostic value of NLR in predicting in-hospital mortality and functional outcome of patients with spontaneous intracerebral hemorrhage will be assessed in this study.

Methods: We retrospectively selected 151 hemorrhagic stroke patients, and demographic and clinical characteristics were collected and computed for NLR. Receiver operating characteristic analysis using Youden's index was utilized to determine the NLR cut-off value with the best sensitivity and specificity. The association of NLR with the in-hospital mortality and functional outcome was assessed using Logistic regression analysis. Pearson Product Model Correlation was employed to evaluate the correlation of NLR with ICH volume.

Results: Admission NLR >7 showed a significant association (p=<0.001 OR 7.99) with in-hospital mortality with a sensitivity of 70.83% and specificity of 72.82%. Furthermore, computed NLR of more than 6.4 showed significant association (p=0.040 OR 2.92) with poor functional outcome. However, our study revealed that admission NLR showed a low level of correlation (r=0.2968, p=0.002) with the volume of ICH.

Conclusion: This study demonstrated that ICH patients with an elevated NLR is associated with increased in-hospital mortality and poor functional outcome and that NLR can be used to predict clinical outcome among patients with spontaneous ICH.

Keywords: functional outcome; in-hospital mortality; intracerebral hemorrhage; neutrophil-to-lymphocyte ratio.

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Conflict of interest statement

There is no potential conflict of interest relevant to this study.

Figures

Figure 1
Figure 1
Flowchart of patient enrollment. ICH: Intracranial hemorrhage; UTI: Urinary tract infection
Figure 2
Figure 2
Receiver operating characteristics curve for in-hospital mortality prediction with NLR >7.
Figure 3
Figure 3
Correlation of NLR and ICH Volume using the Pearson Product Model Correlation.
See this image and copyright information in PMC

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