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Predictive value of the neutrophil-to-lymphocyte ratio in the clinical prognosis of patients with acute intracerebral hemorrhage |
Jiang Min, Gu Shuang-shuang, Cai Nan, Liu Yao, Zhang Qiu-ling, Wang Jun, He Fei |
Department of Emergency Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China |
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Abstract Objective To evaluate the predictive value of neutrophil-to-lymphocyte ratio (NLR) in clinical prognosis of patients with acute intracerebral hemorrhage. Methods We respectively identified the clinical parameters of 172 patients with acute intracerebral hemorrhage. They were divided into good outcome [Glasgow outcome scale (GOS) score >3, n=97] and poor outcome (GOS≤3, n=75) groups based on their 30-day GOS score. The clinical parameters between two groups were analyze univariate comparison. Multivariate logistic regression was applied to identify risk factors of clinical outcome. The correlations among national institute of health stroke scale (NIHSS) and intracerebral hemorrhage score with NLR were analyzed using Spearman′s rank correlation coefficient, respectively. Receiver operating curve (ROC) test was performed to analyze the predictive value of NLR in 30-day clinical outcome of acute intracerebral hemorrhage patients. Results Of the 172 patients included in the study, 114 (66.28%) patients were males and 58 (33.72%) were females with a mean age of (62.95±13.51) years. The total mortality in 30-day was 6.97% (12/172). The hospital stay in poor outcome group were significantly longer than that in good outcome group [(18.48±8.25) days vs. (14.94±5.01) days, P=0.002]. The NLR at admission was an independently risk factor of 30-day clinical outcome of acute intracerebral hemorrhage patients (OR 1.331, 95%CI 1.049~1.689, P=0.019). The NLR was significantly associated with NIHSS (Spearman rho 0.499, P<0.001) and intracerebral hemorrhage score (Spearman rho 0.510, P<0.001). The NLR to predict the clinical outcome of the area under the ROC curve was 0.825 (95%CI0.762~0.886, P=0.000); the optimal cutoff threshold was 4.30, the sensitivity was 85.33% and the specificity was 64.95%, the positive predictive value was 65.31% and negative predictive value of 85.14%. Meanwhile, the positive likelihood ratio was 2.43 and the negative likelihood ratio was 0.23. Conclusion The increased NLR at admission is an independently risk factor of 30-day clinical prognosis of acute intracerebral hemorrhage patients and it is significantly correlated with NIHSS and intracerebral hemorrhage score. Therefore, NLR is useful for predicting prognosis of patients with acute intracerebral hemorrhage.
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Corresponding Authors:
He Fei, E-mail: hefei1201@163.com
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