Neutrophil-lymphocyte ratio predicts prognosis of 90 days after SURGERy in ICH patients

Ref: Zhang F, et alWorld Neurosurg2018 Aug 10pii: S1878-8750 (18) 31791-1doi: 10.1016/j.wneu.2018.08.010The inflammatory response of theplays a vital role in the pathological process of cerebral hemorrhage (ICH)The ratio of neutrophils to lymphocytes (neutrophil to lymphocyte ratio, NLR) has been reported to be an inflammatory marker for predicting the prognosis of ICHHowever, given the effect of surgery on the initiation of inflammatory responses, the use of NLR to assess the surgical prognosis of ICH patients is controversialZhang F, neurosurgery at Huaxi Hospital, Sichuan University, analyzed the nLR and other laboratory parameters of ICH patients when they were admitted to the hospital, predicting the value of the 90-day prognosis after surgery, and the results were published online in August 2018 in World Neurosurgerythe authors collected data on 104 acute ICH patients admitted to Huaxi Hospital from October 2016 to January 2018The results of the neutrophil count, lymphocyte count and total white blood cell number at the time of admission were extracted from the electronic medical record databaseThe relationship between patient NLR and prognosis was assessed through multivariate logistic regression analysisThe performance of the prediction was compared by using the area under the subject's characteristic operating curve (ROC) to compare the NLR with other variables examined in the laboratoryThe average age of 104 ICH patients inwas 50.4 years, of which 80 (76.9%) were male; At 3 months after surgery, the mortality rate was 36.5%, 59 patients had a GOS score of 3 and a poor prognosis, and patients with poor prognosis were admitted to the hospital with low GCS, high hematoma and high NLR, as well as SAH, IVH, or hydrocephalusmultivariate analysis shows that gcS scores at the time of admission (OR-0.692; 95% CI, 0.518-0.925; P-0.01), hematoma (OR-1.148; 95% CI, 1.078 -1.222;P 0.01) and NLR (OR-1.215; 95% CI, 1.015-1.454; P-0.03) are independent predictors of poor prognosis for the 3 months after surgery (Table 1) NLR has better predictive power compared to laboratory inspection of other variables (AUC s 0.668; 95% CI, 0.569-0.757; P 0.01) The best forecast for the NLR is 6.46 Table 1 The relationship between laboratory examination and adverse prognosis 90 days after surgery in ich patients admitted to hospital the authors conclude that the ratio of neutrophils to lymphocytes has independent predictive power for the neurofunction prognosis of 90 days after surgery in patients with cerebral hemorrhage (
Fu compiled, Liu Chenghong, of the First People's Hospital in Changshu City, Jiangsu Province, review, editor-in-chief of "Outside Information" and editor-in-chief of Huashan Hospital, affiliated with Fudan University, Chen Quancheng ) related links