Neutrophil-to-Lymphocyte Ratio as an Independent Predictor of In-Hospital Mortality in Patients with Acute Intracerebral Hemorrhage
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. NLR Assessed at Admission
3.2. NLR Assessed 72 h after Admission
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Parameter (Unit) | Overall n = 201 (100%) | Alive at Discharge n = 111 (55.2%) | In-Hospital Death n = 90 (44.8%) | p |
---|---|---|---|---|
Age (median, 25–75 IQR) | 70 (61–79) | 66 (56–75) | 73 (63–81.25) | 0.001 |
Gender (n, % male) | 111 (55.2%) | 60 (54.1%) | 51 (45.9%) | 0.7 |
Smokers | 33 (16.4%) | 17 (15.3%) | 17 (18.9%) | 0.5 |
Chronic alcohol intake | 48 (23.8%) | 28 (25.2%) | 20 (22.2%) | 0.6 |
Medical History (n, %) | ||||
Previous Ischemic Stroke | 7 (3.5%) | 4 (3.6%) | 3 (3.3%) | 0.9 |
Previous Hemorrhagic Stroke | 27 (13.4%) | 18 (16.2%) | 9 (10%) | 0.2 |
Previous Known Hypertension | 154 (76.5%) | 89 (80%) | 65 (72%) | 0.2 |
Diabetes mellitus | 50 (25%) | 27 (24.3%) | 43 (47.8%) | <0.001 |
Dyslipidemia | 122 (60.7%) | 82 (73.8%) | 40 (44.4%) | <0.001 |
Atrial fibrillation | 27 (13.47%) | 13 (11.8%) | 14 (15.6%) | 0.4 |
Coronary artery disease | 17 (8.5%) | 4 (3.6%) | 13 (14.4%) | 0.009 |
Previous treatment (n, %) | ||||
Previous antiplatelet treatment | 52 (25.8%) | 29 (26.1%) | 23 (25.6%) | 0.9 |
Previous anticoagulant treatment | 25 (12.44%) | 10 (9.01%) | 15 (16.7%) | 0.1 |
Previous antihypertensive treatment | 186 (51%) | 54 (48.6%) | 49 (54.4%) | 0.3 |
Clinical ICH severity (median, 25–75 IQR) | ||||
ICH score | 1 (0–2) | 1 (0–1) | 2 (1–3) | <0.001 |
Admission NIHSS | 16 (6–24) | 10 (4–17) | 25 (16–36) | <0.001 |
Admission GCS | 15 (10–15) | 15 (15–15) | 9.5 (3–14) | <0.001 |
Pre-Stroke mRS | 0 (0–1) | 0 (0–1) | 0 (0–1) | 0.4 |
ICH imaging | ||||
Hematoma Volume (mL, 25–75 IQR) | 13.7 (4.6–35.2) | 7.3 (1.8–19.9) | 27.8 (11.2–63.7) | <0.001 |
HV < 10 mL | 80 (41%) | 62 (57.4%) | 18 (20.7%) | <0.001 |
HV 10–29 mL | 58 (29.7%) | 30 (27.8%) | 28 (32.2%) | |
HV 30–49 mL | 27 (13.8%) | 11 (10.2%) | 16 (18.4%) | |
HV ≥ 50 mL | 30 (15.3%) | 5 (4.6%) | 25 (28.7%) | |
Lobar hemorrhage (n, %) | 50 (24.8%) | 25 (22.5%) | 25 (27.8%) | 0.4 |
Deep hemorrhage (n, %) | 140 (69.6%) | 81 (72.9%) | 59 (65.5%) | 0.2 |
Ventricular effraction (n, %) | 90 (44.9%) | 35 (31.2%) | 56 (62.1%) | <0.001 |
GRAEB score (median, 25–75 IQR) | 0 (0–4) | 0 (0–1) | 2 (0–8) | <0.001 |
Admission Blood Analyses (median, 25–75 IQR) | ||||
Creatinine Clearance (mL/min/1.73 m2) | 79 (55.3–91.4) | 80.8 (59.8–93.1) | 73.5 (49.4–89.5) | 0.07 |
Glucose (mg/dL) | 141 (110.5–191.5) | 126 (104–153) | 176.5 (132–217) | <0.001 |
Glucose > 180 mg/dL (n, %) | 56 (27.8%) | 16 (14.4%) | 40 (44.4%) | <0.001 |
WBC (cells/mm3) | 10,040 (7900–12,950) | 9400 (7820–11,400) | 12,130 (8310–14,922) | <0.001 |
NEUT (cells/mm3) | 7200 (5050–10,250) | 6600 (4900–8600) | 9145 (5750–12,500) | <0.001 |
LYMPHs (cells/mm3) | 1600 (1105–2300) | 1700 (1200–2400) | 1550 (1000–2300) | 0.4 |
MONOs (cells/mm3) | 600 (400–885) | 600 (400–800) | 605 (475–900) | 0.1 |
HGB (g/dL) | 13.8 (12.5–14.9) | 13.9 (12.6–15.4) | 13.4 (12.2–14.7) | 0.05 |
PLTs (cells × 1000/mm3) | 209 (162–268) | 213 (167–267) | 208 (160–270) | 0.9 |
INR | 1.1 (1.04–1.2) | 1.1 (1.04–1.18) | 1.1 (1.06–1.39) | 0.01 |
Admission NLR | 4.3 (2.6–7.8) | 3.7 (2.4–6) | 5.6 (2.9–9.8) | 0.002 |
Univariate Analysis | Multivariate Analysis | |||
---|---|---|---|---|
p-Value | OR (95% CI) | p-Value | OR (95% CI) | |
Age | 0.001 | 1.03 (1.01–1.06) | <0.001 | 1.07 (1.03–1.11) |
Admission NIHSS | <0.001 | 1.15 (1.1–1.2) | <0.001 | 1.13 (1.07–1.19) |
Coronary artery disease | 0.009 | 4.5 (1.4–14.3) | 0.06 | 4.6 (0.9–23.5) |
Admission HV | <0.001 | 1.03 (1.02–1.05) | 0.02 | 1.02 (1.01–1.05) |
Admission GRAEB score | <0.001 | 1.2 (1.1–1.4) | 0.1 | 1.1 (0.9–1.2) |
Creatinine Clearance | 0.07 | 0.99 (0.97–1) | 0.7 | 1.01 (0.9–1.01) |
Glucose >180 mg/dL | <0.001 | 4.7 (2.3–8.7) | 0.006 | 3.9 (1.4–10.5) |
Admission NLR | 0.002 | 1.1 (1.04–1.18) | 0.3 | 1.04 (0.9–1.1) |
Univariate Analysis | Multivariate Analysis | |||
---|---|---|---|---|
p-Value | OR (95% CI) | p-Value | OR (95% CI) | |
Age | 0.01 | 1.05 (1.02–1.08) | 0.02 | 1.05 (1.007–1.1) |
Admission NIHSS | <0.001 | 1.12 (1.07–1.2) | 0.06 | 1.06 (0.9–1.1) |
Admission HV | <0.001 | 1.03 (1.01–1.04) | 0.07 | 1.02 (0.9–1.04) |
Three-day NLR | <0.001 | 1.3 (1.1–1.4) | <0.001 | 1.2 (1.09–1.4) |
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Radu, R.A.; Terecoasă, E.O.; Tiu, C.; Ghiță, C.; Nicula, A.I.; Marinescu, A.N.; Popescu, B.O. Neutrophil-to-Lymphocyte Ratio as an Independent Predictor of In-Hospital Mortality in Patients with Acute Intracerebral Hemorrhage. Medicina 2021, 57, 622. https://doi.org/10.3390/medicina57060622
Radu RA, Terecoasă EO, Tiu C, Ghiță C, Nicula AI, Marinescu AN, Popescu BO. Neutrophil-to-Lymphocyte Ratio as an Independent Predictor of In-Hospital Mortality in Patients with Acute Intracerebral Hemorrhage. Medicina. 2021; 57(6):622. https://doi.org/10.3390/medicina57060622
Chicago/Turabian StyleRadu, Răzvan Alexandru, Elena Oana Terecoasă, Cristina Tiu, Cristina Ghiță, Alina Ioana Nicula, Andreea Nicoleta Marinescu, and Bogdan Ovidiu Popescu. 2021. "Neutrophil-to-Lymphocyte Ratio as an Independent Predictor of In-Hospital Mortality in Patients with Acute Intracerebral Hemorrhage" Medicina 57, no. 6: 622. https://doi.org/10.3390/medicina57060622