Admission neutrophil–lymphocyte ratio predicts delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage
| العنوان: | Admission neutrophil–lymphocyte ratio predicts delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage |
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| المؤلفون: | Michael Schmidt, Vincent Dodson, Nitesh Damodara, Sachin Agarwal, Fawaz Al-Mufti, Philip M. Meyers, Krishna Amuluru, E. Sander Connolly, Jan Claassen, David Roh, Soojin Park |
| المصدر: | Journal of NeuroInterventional Surgery. 11:1135-1140 |
| بيانات النشر: | BMJ, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Subarachnoid hemorrhage, Neutrophils, Ischemia, 030204 cardiovascular system & hematology, Brain Ischemia, Cohort Studies, Sepsis, 03 medical and health sciences, Patient Admission, 0302 clinical medicine, Cerebral vasospasm, Internal medicine, Occlusion, medicine, Humans, Glasgow Coma Scale, Lymphocytes, Prospective Studies, Aged, business.industry, Vasospasm, General Medicine, Middle Aged, Subarachnoid Hemorrhage, medicine.disease, Cardiology, Biomarker (medicine), Female, Surgery, Neurology (clinical), business, Biomarkers, 030217 neurology & neurosurgery |
| الوصف: | BackgroundDelayed cerebral ischemia (DCI) following aneurysmal subarachnoid hemorrhage (aSAH) has a multifactorial pathophysiology, with immune dysregulation being an important component. The neutrophil–lymphocyte ratio (NLR) is an established prognostic marker in patients with cancer, cardiac disease, and sepsis.ObjectiveTo determine whether there is a relationship between NLR and DCI in patients with aSAH.MethodsWe evaluated 1067 patients with aSAH between 2006 and 2015 enrolled in a single-center, prospective, observational cohort study. Admission white blood cell differentials (NLR) were analyzed using a cut-off point of ≥5.9. DCI from cerebral vasospasm was defined as the occurrence of focal neurological impairment, or a decrease in at least two points on the Glasgow Coma Scale, which was not apparent immediately after aneurysm occlusion, and could not be attributed to other causes. Cerebral infarct was defined as a new infarct on CT that was not visible on the admission or immediate postoperative scan, when the cause was thought to be vasospasm by the research team. Logistic regression models were generated.ResultsWe found that 768 (72%) patients had an admission NLR ≥5.9. In a multivariable model, elevated NLR was associated with poor admission Hunt-Hess grade (OR=1.6, 95% CI 1.2 to 2.6, p=0.005), Caucasian ethnicity (OR=2.6, 95% CI 1.9 to 3.7, pConclusionsThis study provides further evidence of the association between inflammation and DCI. Admission NLR is a readily available and convenient biomarker that may be a clinically useful tool for prognostication when evaluating aSAH. |
| تدمد: | 1759-8486 1759-8478 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8058c2fe7e8e43c6b4cb8554df898c77 https://doi.org/10.1136/neurintsurg-2019-014759 |
| رقم الأكسشن: | edsair.doi.dedup.....8058c2fe7e8e43c6b4cb8554df898c77 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 17598486 17598478 |
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