Neutrophil and Platelet to Lymphocyte Ratios in Associating with Blood Glucose Admission Predict the Functional Outcomes of Patients with Primary Brainstem Hemorrhage.

Because of a lack of markers for predicting prognosis and an underlying mechanism, patients with primary brainstem hemorrhage (PBH) are currently treated with multiple strategies, but most of them have poor outcomes in a comparison with patients with supratentorial intracranial hemorrhage. Recently, it has been reported that the neutrophil-to-lymphocyte ratio (NLR) represents a novel composite inflammatory marker to predict the prognosis of patients with intracranial hemorrhage, a majority of whom have supratentorial hemorrhage. In this report, we aim to assess the potential predictive value of NLR in patients with PBH. In addition, other available laboratory parameters, including platelet-to-lymphocyte ratio (PLR), and admission blood glucose level (ABG), will be also investigated as markers for prognosis in patients with PBH. This study retrospectively enrolled 225 patients with acute PBH who were admitted West China Hospital from January 2012 to December 2016. ABG and absolute numbers of neutrophils, lymphocytes, white blood cells, and platelets were extracted from electronic medical records. ABG, NLR, and PLR were calculated and further assessed using multivariable logistic regression analysis for understanding the associations of treatment outcomes. The comparison of predictive power of independent predictors was evaluated using receiver operating characteristic. Of 225 inpatients, NLR (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.24-2.62, P < 0.01), PLR (OR, 1.43; 95% CI, 1.11-2.36; P = 0.013), and ABG (OR, 6.57; 95% CI, 2.78-15.52; P < 0.01) were independently associated with 90-day status in 112 patients with unfavorable outcomes. All 3 parameters also correlated with admission Glasgow Coma Scale score (r = -0.244, P < 0.001; r = -0.292, P < 0.001; r = -0.661, P < 0.01) and absolute neutrophil counts (r = 0.645, P < 0.001; r = 0.347, P < 0.001; r = 0.695, P < 0.01). Meanwhile, NLR exhibits a comparable predictive power by comparing with PLR (area under the curve [AUC], 0.694; 95% CI, 0.626-0.764; P < 0.001; versus AUC, 0.662; 95% CI, 0.596-0.724; P < 0.001). In addition, ABG shows a positive predictive value (AUC, 0.784; 95% CI, 0.725-0.832; P < 0.001). The best independent predictive cutoff points were 6.65, 59.3, and 7.81 mmol/L for NLR, PLR, and ABG, respectively. Nevertheless, a combination of 3 parameters shows the best predictive ability (AUC, 0.835; 95% CI, 0.781-0.883; P < 0.001). NLR, PLR, and ABG can be used to independently predict 90-day functional outcome in patients after PBH. When combined, they have better predictive power in identifying PBH patients with a poor prognosis. To our knowledge, this study is the first to reveal the associations between NLR, PLR, and hyperglycemia and the functional outcomes of patient with PBH. In associating with previously studies on hemorrhage site, our results provide a good opportunity to elucidate the underlying mechanisms of PBH.

Fan Z ，Hao L ，Chuanyuan T ，Jun Z ，Xin H ，Sen L ，Juan Q ，Cao Y ，Mu Y ... -  《-》

Association of Neutrophil to Lymphocyte Ratio on 90-Day Functional Outcome in Patients with Intracerebral Hemorrhage Undergoing Surgical Treatment.

The inflammatory response plays a vital role in the pathologic mechanism of intracerebral hemorrhage. It recently has been reported that neutrophil to lymphocyte ratio (NLR) could represent a novel composite inflammatory marker for predicting the prognosis of intracranial hemorrhage (ICH). However, in considering the effects of surgical evacuation on the initiation of inflammatory responses, the relationship between NLR and functional outcome of patients with ICH after surgical treatment is still controversial. Here, we aimed to assess the predictive value of admission NLR and other available laboratory parameters for 90-day outcome of patients with ICH undergoing neurosurgical treatment. In total, 104 patients with acute ICH admitted to West China Hospital from October 2016 to January 2018 were retrospectively enrolled. Admission absolute neutrophil count, lymphocyte count, and white blood count were extracted from electronic medical records of patents with ICH. The associations between outcome and laboratory biomarkers were assessed by multivariable logistic regression analysis. The comparison of predictive power of independent predictors was evaluated by receiver operating characteristic curves. In total, 59 patients with ICH who underwent surgical treatment exhibited unfavorable outcomes, which was associated with greater admission NLR (odds ratio [OR] 0.692, 95% confidence interval [CI] 0.518-0.925, P = 0.01; OR 1.148, 95% CI 1.078-1.222, P < 0.01; OR 1.215, 95% CI 1.015-1.454, P = 0.03), lower Glasgow Coma Scale score, and larger hematoma. NLR showed the best predictive power by comparing with other laboratorial variables (area under the curve 0.668, 95% CI 0.569-0.757, P < 0.01) and also was found to linearly correlate with Glasgow Coma Scale score at admission, hematoma volume, absolute neutrophil count, absolute lymphocyte count, and hydrocephalus. Meanwhile, the best predictive cutoff point of 6.46 for NLR also was identified. Other than the association of prognosis of patients with ICH, NLR exhibited potential independent predictive ability for 90-day functional outcomes of patients with ICH after surgery.

Zhang F ，Tao C ，Hu X ，Qian J ，Li X ，You C ，Jiang Y ，Yang M ... -  《-》

Predictive ability of admission neutrophil to lymphocyte ratio on short-term outcome in patients with spontaneous cerebellar hemorrhage.

Zhang F ，Ren Y ，Shi Y ，Fu W ，Tao C ，Li X ，Yang M ，You C ，Xin T ... -  《-》

Clinical Value of Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratio After Aneurysmal Subarachnoid Hemorrhage.

Tao C ，Wang J ，Hu X ，Ma J ，Li H ，You C ... -  《-》

Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Are Effective Predictors of Prognosis in Patients with Acute Mesenteric Arterial Embolism and Thrombosis.

The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been shown to be valuable prognostic markers for a variety of pathological conditions including solid tumors, sepsis, and others. However, the prognostic values of the NLR and PLR in patients with acute mesenteric arterial embolism (AMAE) and acute mesenteric arterial thrombosis (AMAT) have not been elucidated. The aim of this study was to determine the predictive value of the NLR and PLR for poor prognosis in patients with AMAE and AMAT. A total of 137 patients with AMAE (n = 77) or AMAT (n = 60) were divided into a poor outcome group (cases of intestinal necrosis or death) and a better outcome group (cases without intestinal necrosis who survived successfully), according to prognosis. Neutrophil, platelet, and lymphocyte counts were recorded before pharmacotherapy or surgery. The NLR and PLR were calculated, and logistic regression analysis was performed to test their prognostic values. The cutoff values for NLR and PLR were 11.05 and 156.26, respectively. The PLR was linearly associated with the NLR (R = 0.769, P < 0.001). NLR (odds ratio [OR] = 6.835, 95% confidence interval [CI] = 2.282-20.469, P = 0.001), PLR (OR = 4.871, 95% CI = 1.627-14.587, P = 0.005), and coronary heart disease (OR = 3.388, 95% CI = 1.156-9.929, P = 0.026) were found to be independent prognostic factors for the patients. NLR ≥ 11.05, PLR ≥ 156.26, and coronary heart disease were shown to be risk factors for poor prognosis in patients with AMAE and AMAT. According to these factors, patients can be divided into 3 prognostic groups: good, NLR < 11.05 with PLR < 156.26; moderate, NLR < 11.05 with PLR ≥ 156.26 or NLR ≥ 11.05 with PLR < 156.26; and poor, NLR ≥ 11.05 with PLR ≥ 156.26.

Wang S ，Liu H ，Wang Q ，Cheng Z ，Sun S ，Zhang Y ，Sun X ，Wang Z ，Ren L ... -  《-》