1
|
Luo Y, Zhao J. The dynamic changes of peripheral blood cell counts predict the clinical outcomes of aneurysmal subarachnoid hemorrhage. Heliyon 2024; 10:e29763. [PMID: 38681624 PMCID: PMC11053216 DOI: 10.1016/j.heliyon.2024.e29763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 04/12/2024] [Accepted: 04/15/2024] [Indexed: 05/01/2024] Open
Abstract
Background Aneurysmal subarachnoid hemorrhage (aSAH) is a serious type of hemorrhagic stroke. It is very important to predict the prognosis at early phase. In this work, we intend to characterize early changes in peripheral blood cells after aSAH and explore the association between peripheral blood cells and clinical outcomes after aSAH. Methods aSAH patients admitted between December 2019 and September 2022 were enrolled. A retrospective observational study was performed. Total leukocytes, monocytes, neutrophils, erythrocytes, lymphocytes and platelets counts were recorded on the day of admission (day 1), day 3, day 5 and day 7. Statistical tests included Chi-square test, analysis of variance and multivariate logistic regression (MLR) models. 197 patients were analyzed. Results Leukocytes and neutrophils were higher in poor outcome groups from day 1 to day 7 and in delayed cerebral ischemia (DCI) groups from day 3 to day 7. Lymphocytes were higher at day 5 and day 7 in good outcome groups and no DCI groups. Neutrophil-to-lymphocyte ratio (NLR) was lower from day 3 to day 7 in good outcome groups and no DCI groups. Erythrocytes were higher from day 3 to day 7 in good outcome groups and no DCI groups. Lymphocytes were negatively related to poor outcomes on day 1 (OR = 0.457), indicating higher lymphocytes predicted good outcomes, Neutrophils were positively related to poor outcomes on day 3 (OR = 3.003) indicating higher neutrophils predicted poor outcomes. Lymphocytes were negatively related to DCI on day 5 (OR = 0.388) indicating higher lymphocytes predicted no DCI, Erythrocytes were negatively related to DCI on day 5 (OR = 0.335) and day 7 (OR = 0.204) indicating higher erythrocytes predicted no DCI. The improved ability of neutrophils, lymphocytes and erythrocytes to predict DCI or poor functional outcomes were revealed by ROC curve analysis. Conclusions The dynamic changes of peripheral blood cell counts were related to poor functional outcomes and DCI after aSAH. Elevated neutrophils, leukocytes, NLR, and decreased lymphocytes, erythrocytes were accompanied by DCI and poor outcome. Neutrophils, lymphocytes and erythrocytes counts could be beneficial to predict DCI and outcomes after aSAH.
Collapse
Affiliation(s)
- Yi Luo
- Department of Neurology, The First People's Hospital of Jing Zhou, The First Affiliated Hospital of Yangtze University, Jing zhou, 434000, China
- Department of Stroke Center, The First People's Hospital of Jing Zhou, The First Affiliated Hospital of Yangtze University, Jing zhou, 434000, China
| | - Jian Zhao
- Department of Neurosurgery, The First People's Hospital of Jing Zhou, The First Affiliated Hospital of Yangtze University, Jing zhou, 434000, China
- Department of Stroke Center, The First People's Hospital of Jing Zhou, The First Affiliated Hospital of Yangtze University, Jing zhou, 434000, China
| |
Collapse
|
2
|
Osunronbi T, Olukoya O, Jesuyajolu D, Alare K, Alemenzohu HO, Bello RO, Omoniyo T, Oyeyemi OV, Yakasai AN, Sharma H. The prognostic utility of neutrophil-lymphocyte ratio in spinal surgery: A systematic review and meta-analysis. J Clin Neurosci 2024; 121:161-168. [PMID: 38412749 DOI: 10.1016/j.jocn.2024.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 02/18/2024] [Indexed: 02/29/2024]
Abstract
PURPOSE Neutrophil-lymphocyte ratio (NLR) is reportedly an effective prognostic tool across various medical and surgical fields, but its value in spinal surgery is unestablished. We aim to investigate the relationship between elevated baseline/postoperative NLR and patient outcomes in spinal surgery. MATERIALS AND METHODS We performed a systematic search in PubMed, EMBASE, and SCOPUS databases for studies investigating the prognostic value of NLR in spine patients.Odds ratios (ORs) and hazard ratios (HRs) with 95% confidence intervals (CIs) were analysed on the RevMan 5.4 software. Where meta-analysis was not possible, we vote-counted the direction of the effect of elevated NLR. The GRADE framework for prognostic factor research was utilised to assess the certainty of the evidence for each outcome measure. RESULTS Five outcome measures (overall survival, mortality, disease-free survival, functional recovery and complications) were assessed across 16 studies involving 5471 patients. Elevated baseline NLR was associated with reduced overall survival (HR: 1.63, 95 % CI: 1.05 - 2.54) (GRADE: low) and worsened functional recovery (OR: 0.93, 95 % CI: 0.87 - 0.98) (GRADE: low). There was no association between baseline NLR and disease-free survival (HR: 2.42, 95 % CI: 0.49 - 11.83) (GRADE: very low) or mortality (OR: 1.39, 95 % CI: 0.41 - 4.75) (GRADE: very low). Elevated NLR levels measured on days 3-4 and days 6-7 postoperatively, but not NLR measured at baseline or on days 1-2 postoperatively, were associated with greater risks of complications (GRADE: low). CONCLUSIONS NLR is an objective tool with the potential to identify the patients that would benefit from surgery and facilitate shared decision-making.
Collapse
Affiliation(s)
- Temidayo Osunronbi
- Neurosurgery Section, Surgery Interest Group of Africa, Lagos, Nigeria; Department of Health Sciences, University of York, York, United Kingdom.
| | - Olatomiwa Olukoya
- Neurosurgery Section, Surgery Interest Group of Africa, Lagos, Nigeria
| | | | - Kehinde Alare
- Neurosurgery Section, Surgery Interest Group of Africa, Lagos, Nigeria
| | | | - Raheem O Bello
- Neurosurgery Section, Surgery Interest Group of Africa, Lagos, Nigeria
| | - Taiwo Omoniyo
- Neurosurgery Section, Surgery Interest Group of Africa, Lagos, Nigeria
| | - Opeyemi V Oyeyemi
- Neurosurgery Section, Surgery Interest Group of Africa, Lagos, Nigeria
| | - Amina N Yakasai
- Neurosurgery Section, Surgery Interest Group of Africa, Lagos, Nigeria
| | - Himanshu Sharma
- Southwest Neurosurgery Centre, University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom
| |
Collapse
|
3
|
Zhang R, Zhang Y, Liu Z, Pei Y, He Y, Yu J, You C, Ma L, Fang F. Association between neutrophil-to-albumin ratio and long-term mortality of aneurysmal subarachnoid hemorrhage. BMC Neurol 2023; 23:374. [PMID: 37858065 PMCID: PMC10585913 DOI: 10.1186/s12883-023-03433-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 10/10/2023] [Indexed: 10/21/2023] Open
Abstract
OBJECTIVE The prognosis of aneurysmal subarachnoid hemorrhage (aSAH) survivors is concerning. The goal of this study was to investigate and demonstrate the relationship between the neutrophil-to-albumin ratio (NAR) and long-term mortality of aSAH survivors. METHODS A retrospective observational cohort study was conducted at Sichuan University West China Hospital between January 2009 and June 2019. The investigation of relationship between NAR and long-term mortality was conducted using univariable and multivariable Cox regression models. To demonstrate the predictive performance of different biomarkers over time, time-dependent receiver operating characteristic curve (ROC) analysis and decision curve analysis (DCA) were created. RESULTS In total, 3173 aSAH patients were included in this study. There was a strong and continuous relationship between NAR levels and long-term mortality (HR 3.23 95% CI 2.75-3.79, p < 0.001). After adjustment, the result was still significant (adjusted HR 1.78 95% CI 1.49-2.12). Compared with patients with the lowest quartile (< 0.15) of NAR levels, the risk of long-term mortality in the other groups was higher (0.15-0.20: adjusted HR 1.30 95% CI 0.97-1.73; 0.20-0.28: adjusted HR 1.37 95% CI 1.03-1.82; >0.28: adjusted HR 1.74 95% CI 1.30-2.32). Results in survivors were found to be still robust. Moreover, out of all the inflammatory markers studied, NAR demonstrated the highest correlation with long-term mortality. CONCLUSIONS A high level of NAR was associated with increased long-term mortality among patients with aSAH. NAR was a promising inflammatory marker for long-term mortality of aSAH.
Collapse
Affiliation(s)
- Renjie Zhang
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yu Zhang
- Center for Evidence Based Medical and Clinical Research, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China
| | - Zheran Liu
- Department of Biotherapy, Cancer Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yiyan Pei
- Department of Biotherapy, Cancer Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yan He
- Department of Biotherapy, Cancer Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Jiayi Yu
- School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Chao You
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Lu Ma
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
| | - Fang Fang
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
| |
Collapse
|
4
|
Wu Y, Zhao Z, Kang S, Zhang L, Lv F. Potential application of peripheral blood biomarkers in intracranial aneurysms. Front Neurol 2023; 14:1273341. [PMID: 37928138 PMCID: PMC10620808 DOI: 10.3389/fneur.2023.1273341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 10/05/2023] [Indexed: 11/07/2023] Open
Abstract
Intracranial aneurysm (IA) counts are increasing yearly, with a high mortality and disability after rupture. Current diagnosis and treatment rely on costly equipment, lacking effective indicators for progression prediction and specific drugs for treatment. Recently, peripheral blood biomarkers, as common clinical test samples, reflecting the immune and inflammatory state of the body in real-time, have shown promise in providing additional information for risk stratification and treatment in IA patients, which may improve their outcomes after aneurysm rupture through anti-inflammatory therapy. Therefore, this paper reviewed the progress of potential biomarkers of IAs, including inflammatory blood indicators, cytokines, and blood lipids, aiming to aid individual management and therapy of aneurysms in clinical practices.
Collapse
Affiliation(s)
- Yangying Wu
- Department of Radiology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Ziya Zhao
- Department of Radiology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Shaolei Kang
- Department of Radiology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
- The Department of Medical Imaging, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Lijuan Zhang
- Department of Radiology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Fajin Lv
- Department of Radiology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| |
Collapse
|
5
|
Oliveira AJMD, Rabelo NN, Telles JPM, Solla DJF, Coelho ACSDS, Barbosa GB, Barbato NC, Yoshikawa MH, Teixeira MJ, Figueiredo EG. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios and prognosis after aneurysmal subarachnoid hemorrhage: a cohort study. Arq Neuropsiquiatr 2023; 81:515-523. [PMID: 37379863 DOI: 10.1055/s-0043-1768662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
BACKGROUND Subarachnoid hemorrhage (SAH) prognosis remains poor. Vasospasm mechanism might be associated with inflammation. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been studied as inflammation markers and prognostic predictors. OBJECTIVE We aimed to investigate NLR and PLR in admission as predictors of angiographic vasospasm and functional outcome at 6 months. METHODS This cohort study included consecutive aneurysmal SAH patients admitted to a tertiary center. Complete blood count was recorded at admission before treatment. White blood cell count, neutrophil count, lymphocyte count, platelet count, NLR, and PLR were collected as independent variables. Vasospasm occurrence-modified Rankin scale (mRS), Glasgow outcome scale (GOS), and Hunt-Hess score at admission and at 6 months were recorded as dependent variables. Multivariable logistic regression models were used to adjust for potential confounding and to assess the independent prognostic value of NLR and PLR at admission. RESULTS A total of 74.1% of the patients were female, with mean age of 55.6 ± 12.4 years. At admission, the median Hunt-Hess score was 2 (interquartile range [IQR] 1), and the median mFisher was 3 (IQR 1). Microsurgical clipping was the treatment for 66.2% of the patients. Angiographic vasospasm incidence was 16.5%. At 6 months, the median GOS was 4 (IQR 0.75), and the median mRS was 3 (IQR 1.5). Twenty-one patients (15.1%) died. Neutrophil-to-lymphocyte ratio and PLR levels did not differ between favorable and unfavorable (mRS > 2 or GOS < 4) functional outcomes. No variables were significantly associated with angiographic vasospasm. CONCLUSION Admission NLR and PLR presented no value for prediction of functional outcome or angiographic vasospasm risk. Further research is needed in this field.
Collapse
Affiliation(s)
- Adilson Jose Manuel de Oliveira
- Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Divisão de Neurocirurgia, São Paulo SP, Brazil
- Clínica Girassol, Divisão de Neurocirurgia, Luanda, Angola
| | - Nicollas Nunes Rabelo
- Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Divisão de Neurocirurgia, São Paulo SP, Brazil
| | - João Paulo Mota Telles
- Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Divisão de Neurocirurgia, São Paulo SP, Brazil
| | - Davi Jorge Fontoura Solla
- Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Divisão de Neurologia, São Paulo SP, Brazil
| | | | | | | | - Marcia Harumy Yoshikawa
- Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina, São Paulo SP, Brazil
| | - Manoel Jacobsen Teixeira
- Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Divisão de Neurocirurgia, São Paulo SP, Brazil
| | - Eberval Gadelha Figueiredo
- Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Divisão de Neurocirurgia, São Paulo SP, Brazil
| |
Collapse
|
6
|
Bacigaluppi S, Bragazzi NL, Ivaldi F, Benvenuto F, Uccelli A, Zona G. Systemic Inflammatory Response in Spontaneous Subarachnoid Hemorrhage from Aneurysmal Rupture versus Subarachnoid Hemorrhage of Unknown Origin. J Inflamm Res 2022; 15:6329-6342. [PMID: 36415221 PMCID: PMC9676007 DOI: 10.2147/jir.s380101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/26/2022] [Indexed: 09/09/2023] Open
Abstract
OBJECTIVE It is well known that spontaneous non-aneurysmal subarachnoid hemorrhage (SAH), also known as sine materia SAH (smSAH), has usually a better course and prognosis than its aneurysmal counterpart (aSAH). This might depend on different inflammatory mechanisms initiated by bleeding events of different origins. The aim of the present study was to explore the systemic inflammatory response in spontaneous SAH, comparing aSAH and smSAH. METHODS We performed a prospective observational study over a consecutive series of patients with SAH. For these patients, we collected all clinical data and, furthermore, performed venous blood sampling over six time points to analyze blood cells. We further performed the analysis of lymphocytes and monocytes by means of flow cytometry to quantify common subtypes. Statistical analysis included a t-student test, Chi-square test, multivariate logistic regression, and ROC analysis. RESULTS 48 patients were included: six (12.5%) with a diagnosis of spontaneous smSAH, and forty-two patients (87.5%) with aSAH. Significant differences on Day 0 were found for neutrophils and a systemic neuro-inflammatory index, namely, systemic inflammatory response index (SIRI). At the ROC analysis, neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and SIRI exhibited satisfactory predictive power on day 0. At the multivariable logistic regression analysis, the combined index (NLR, LMR, SIRI at day 0) yielded an OR of 0.59 (95% CI 0.29-1.21]). LMR at day 0 yielded an OR of 1.25 ([95% CI 0.94-1.68]), NLR at day 0 exhibited an OR of 0.68 ([95% CI 0.42-1.09]), and SIRI at day 0 displayed an OR of 0.31 ([95% CI 0.06-1.49]). CONCLUSION This preliminary study indicated a possible role of some inflammatory indices that point out the importance of innate and adaptive immunity in the etiopathogenetic mechanisms. Drugs modulating these responses could eventually counteract or, at least, reduce secondary damage associated with SAH.
Collapse
Affiliation(s)
- Susanna Bacigaluppi
- DINOGMI, University of Genoa, Genoa, Italy
- Department of Neurosurgery and Neurotraumatology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neurosurgery, E.O. Ospedali Galliera, Genoa, Italy
| | | | | | | | - Antonio Uccelli
- DINOGMI, University of Genoa, Genoa, Italy
- Department of Neurology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Gianluigi Zona
- DINOGMI, University of Genoa, Genoa, Italy
- Department of Neurosurgery and Neurotraumatology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| |
Collapse
|
7
|
Shi M, Li XF, Zhang TB, Tang QW, Peng M, Zhao WY. Prognostic Role of the Neutrophil-to-Lymphocyte Ratio in Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis. Front Neurosci 2022; 16:825859. [PMID: 35360156 PMCID: PMC8960242 DOI: 10.3389/fnins.2022.825859] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 02/07/2022] [Indexed: 01/04/2023] Open
Abstract
The neutrophil-to-lymphocyte ratio (NLR) plays an important role in the progression of intracerebral hemorrhage (ICH). An increasing number of studies have reported that a high NLR is correlated with poor clinical outcomes among patients with ICH. Here, we conducted a systematic review and meta-analysis to evaluate the prognostic value of NLR in the setting of ICH. We performed a comprehensive search of electronic literature databases to identify all relevant studies evaluating the prognostic role of NLR in patients with ICH. Two researchers independently screened the studies and extracted relevant data. We extracted, pooled, and weighted odds ratio (OR) and 95% confidence interval (CI) values using a generic inverse-variance method, and then evaluated the heterogeneity among studies using Q test and I2 statistic. Finally, we selected a total of 26 studies including 7,317 patients for the current study. Overall, our results indicated that a high NLR was significantly associated with a poor outcome (OR, 1.32; 95% CI, 1.19–1.46; P < 0.00001), mortality (OR, 1.05; 95% CI, 1.01–1.09; P = 0.02), and neurological deterioration (OR, 1.65; 95% CI, 1.08–2.52; P = 0.02). We did not observe a significant association between NLR and hematoma expansion (OR, 1.04; 95% CI, 0.99–1.08; P = 0.09). Our study indicated that a high NLR is significantly associated with poor clinical outcomes in patients with ICH. As NLR is a simple and easily available biomarker, future studies should focus on exploring its application in the prognostic evaluation of patients with ICH.
Collapse
Affiliation(s)
- Min Shi
- Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xiao-feng Li
- Department of Anesthesiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Ting-bao Zhang
- Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Qing-wen Tang
- Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Mian Peng
- Department of Anesthesiology, Zhongnan Hospital of Wuhan University, Wuhan, China
- Mian Peng,
| | - Wen-yuan Zhao
- Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China
- *Correspondence: Wen-yuan Zhao,
| |
Collapse
|
8
|
Shi M, Yang C, Tang QW, Xiao LF, Chen ZH, Zhao WY. The Prognostic Value of Neutrophil-to-Lymphocyte Ratio in Patients With Aneurysmal Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis of Observational Studies. Front Neurol 2021; 12:745560. [PMID: 34867727 PMCID: PMC8636120 DOI: 10.3389/fneur.2021.745560] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/12/2021] [Indexed: 12/26/2022] Open
Abstract
The neutrophil–to-lymphocyte ratio (NLR), as an essential systemic inflammation factor, has been widely used as a prognostic indicator in various diseases, such as malignant tumors, cardiovascular disease, and intracranial hemorrhage. An increasing number of studies have believed that NLR is a valuable predictor of prognosis for patients with aneurysmal subarachnoid hemorrhage (aSAH). However, these results remain controversial. In the current study, we planned to carry out a systematic review and meta-analysis to investigate the association between NLR and poor outcome, and the occurrence of delayed cerebral ischemia (DCI). We carried out a comprehensive search for published literatures on PubMed, EMBASE, Cochrane Library, and Web of Science databases from inception to April 1, 2021. We conducted an assessment of all included studies based on the principles proposed in the Newcastle-Ottawa Quality Assessment Scale (NOS). Poor outcome and the occurrence of DCI were considered as the main outcome measure. We calculated the pooled odds ratio (OR) and corresponding 95% confidence interval (CI) to examine the strength of the association of NLR with poor outcome or the occurrence of DCI. We strictly selected a total of 10 studies comprising 4,989 patients. Nine studies reported the association between NLR and poor outcome, and five studies reported the association between NLR and the occurrence of DCI. The pooled results indicated higher NLR was significantly associated with both poorer outcomes (OR = 1.32, 95%CI 1.11–1.57; P = 0.002, I2 = 87%), and the occurrence of DCI (OR = 1.72, 95%CI 1.22–2.41; P = 0.002, I2 = 82%) in aSAH patients. The NLR is a valuable indicator of inflammation to independently predict poor outcome and occurrence of DCI after aSAH, where a higher NLR is significantly associated with poor outcomes and occurrence of DCI. These findings suggest that the NLR can help clinicians evaluate the prognosis and identify potentially severe patients early, which may contribute to better management and improve poor prognosis of aSAH patients.
Collapse
Affiliation(s)
- Min Shi
- Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Chao Yang
- Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Qing-Wen Tang
- Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Ling-Fei Xiao
- Department of Orthopaedics, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Zu-Han Chen
- Institute of Hepatobiliary Diseases of Wuhan University, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Wen-Yuan Zhao
- Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| |
Collapse
|
9
|
Luo F, Li Y, Zhao Y, Sun M, He Q, Wen R, Xie Z. Systemic immune-inflammation index predicts the outcome after aneurysmal subarachnoid hemorrhage. Neurosurg Rev 2021; 45:1607-1615. [PMID: 34718917 DOI: 10.1007/s10143-021-01681-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/12/2021] [Accepted: 10/22/2021] [Indexed: 02/05/2023]
Abstract
Systemic inflammatory response is closely related to the pathogenesis and prognosis in critical patients. Recently, systemic immune-inflammation index (SII), an indicator of systemic inflammatory response, was proved to predict the outcome in cancerous and non-cancerous diseases. The aim of this study is to investigate the association between SII on admission and 6-month outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH). The clinical data and prognosis of 76 patients with aSAH were analyzed. The 6-month outcome was assessed by the modified Rankin scale(mRS). The unfavorable outcome was defined as mRS score ≥ 3. In addition, multivariate analysis was conducted to investigate factors independently associated with the favorable outcome. Receiver operating characteristic (ROC) curve analysis was undertaken to identify the best cut-off value of SII for the discriminate between favorable and unfavorable outcome in these patients. Thirty-six patients (47.4%) in our study had an unfavorable outcome (mRS ≥ 3) at 6 months, and twenty-four (66.7%) of them were in the high-SII group. A significantly higher SII on admission was observed in patients with unfavorable functional outcome at 6 months. Binary logistic regression analysis showed that there was an independent association between SII on admission and 6-month clinical outcome (adjusted OR = 4.499, 95%CI: 1.242-16.295, P < 0.05). The AUC of the SII for predicting unfavorable outcome was 0.692 (95% CI: 0.571-0.814, P < 0.05). Systemic immune-inflammation index (SII) could be a novel independent prognostic factor for aSAH patients at the early stage of the disease.
Collapse
Affiliation(s)
- Fushu Luo
- Department of Neurosurgery, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Yuanyou Li
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yutong Zhao
- Department of Neurosurgery, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Mingjiang Sun
- Department of Neurosurgery, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Qiuguang He
- Department of Neurosurgery, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Rong Wen
- Department of Neurosurgery, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Zongyi Xie
- Department of Neurosurgery, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
| |
Collapse
|
10
|
Gomes Dos Santos A, de Carvalho RF, de Morais ANLR, Silva TM, Baylão VMR, Azevedo M, de Oliveira AJM. Role of neutrophil-lymphocyte ratio as a predictive factor of glioma tumor grade: A systematic review. Crit Rev Oncol Hematol 2021; 163:103372. [PMID: 34062242 DOI: 10.1016/j.critrevonc.2021.103372] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 05/07/2021] [Accepted: 05/11/2021] [Indexed: 01/03/2023] Open
Abstract
Gliomas are the main type of intra-axial primary brain tumors. We performed a systematic review of studies on the neutrophil-to-lymphocyte ratio (NLR) and its role in the prognosis of patients with gliomas. An English-language literature-based search, using the PubMed and Biblioteca Virtual em Saúde databases, was conducted for papers published until May 2, 2020. The quality of the selected articles was stratified using the Newcastle-Ottawa scale's criteria. We found 137 publications for a query string. After applying the inclusion criteria, 13 articles were selected. Seven studies assessed overall survival and found high NLR values associated with poor overall survival. Six studies approached the issue of tumor grading and differential diagnosis and demonstrated that patients with high NLR values were diagnosed with high-grade gliomas. NLR is a low-cost method and an effective prognostic factor associated with tumor grading and OS in patients with gliomas.
Collapse
|
11
|
Liu X, Yu Z, Wen D, Ma L, You C. Prognostic value of albumin-fibrinogen ratio in subarachnoid hemorrhage patients. Medicine (Baltimore) 2021; 100:e25764. [PMID: 33907173 PMCID: PMC8084098 DOI: 10.1097/md.0000000000025764] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/30/2021] [Accepted: 04/13/2021] [Indexed: 02/05/2023] Open
Abstract
ABSTRACT Inflammation plays an important role in the pathophysiology of subarachnoid hemorrhage (SAH). Recent studies have indicated that the albumin to fibrinogen ratio (AFR) is a useful biomarker of inflammation.This research aimed to determine the ability of AFR to predict the prognosis of patients with SAH.A total of 440 patients with SAH who had been diagnosed within 72 hours of symptom onset were retrospectively reviewed. Clinical findings and laboratory data were retrieved from the hospital database. Functional outcome was measured according to the modified Rankin scale at 30 days. Logistic regression analysis was used to evaluate the correlation between AFR and the prognosis of patients with SAH. Receiver operating characteristic (ROC) analysis was performed to determine the prognostic ability of AFR at admission to predict the 30-day outcomes.The average age of all 440 patients with SAH was 56.75 ± 11.19 years and 31.4% (138) were male. Of these patients, 161 exhibited unfavorable outcomes at 30 days. According to the multivariate logistic regression analysis, the AFR was positively correlated with the outcome of patients with SAH (odds ratio 0.939, 95% confidence interval 0.885-0.996, P = .038). The ROC analysis revealed an area under the curve of 0.713 for AFR's ability to predict the 30-day outcomes.AFR is independently associated with the outcome of SAH patients. As a parameter that can be easily assessed at admission, AFR could be used to help the decision-making of clinical treatment.
Collapse
|