Abstract
Background Recent studies of patients with intracerebral hemorrhage suggest an association between
peripheral blood neutrophil-lymphocyte ratio and neurologic deterioration. We aimed
to study the prognostic utility of neutrophil-lymphocyte ratio in predicting inpatient
mortality in aneurysmal subarachnoid hemorrhage. Methods We conducted a retrospective electronic medical record review of the clinical, laboratory,
and radiographic data of patients with aneurysmal subarachnoid hemorrhage 18 years
of age or older presenting to the neuroscience intensive care unit from January 1,
2011, to December 31, 2017. Patients with aneurysmal subarachnoid hemorrhage were
divided into 2 groups (group 1, alive at discharge; group 2, deceased prior to discharge),
and neutrophil-lymphocyte ratio laboratory mean values were recorded for each patient.
Our primary outcome measure was inpatient mortality, and our secondary measure was
incidence of pneumonia with hospitalization. Results We identified 403 patients with aneurysmal subarachnoid hemorrhage for the study.
After exclusion criteria, 44 eligible patients were divided into the 2 groups (group
1, n = 32; group 2, n = 12). Mean neutrophil-lymphocyte ratio for group 1 was 11.53,
and for group 2, 17.85 (P < .01). The mean neutrophil-lymphocyte ratio of those who developed pneumonia compared
to those who did not was 15.28 versus 12.81, respectively (P = .39). A Kaplan-Meier plot demonstrated increased mortality among patients with
a neutrophil-lymphocyte ratio equal to or greater than 12.5 compared to those with
a neutrophil-lymphocyte ratio less than 12.5. Conclusions These preliminary data demonstrate that a neutrophil-lymphocyte ratio equal to or
greater than 12.5 at admission predict higher inpatient mortality in patients with
aneurysmal subarachnoid hemorrhage.
Key Words
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Article info
Publication history
Published online: January 18, 2020
Accepted:
December 22,
2019
Received:
December 2,
2019
Footnotes
Funding: Mayo Clinic Center for Regenerative Medicine.
Portions of the data in this manuscript were presented in a poster at Mayo Clinic Cerebrovascular Update and Controversies CME Neurology and Neurosurgery in Las Vegas, Nevada, March 23, 2018.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.104631
Copyright
© 2019 Elsevier Inc. All rights reserved.
