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Article

Neutrophil-to-Lymphocyte Ratio as an Independent Predictor of In-Hospital Mortality in Patients with Acute Intracerebral Hemorrhage

1
“Carol Davila” University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania
2
Department of Neurology, University Emergency Hospital Bucharest, 050098 Bucharest, Romania
3
Department of Radiology and Medical Imaging, University Emergency Hospital Bucharest, 050098 Bucharest, Romania
4
Department of Neurology, Colentina Clinical Hospital, 020125 Bucharest, Romania
5
Laboratory of Cell Biology, Neurosciences and Experimental Myology, ‘Victor Babes’ National Institute of Pathology, 050096 Bucharest, Romania
*
Author to whom correspondence should be addressed.
Academic Editor: Stavros J. Baloyannis
Received: 20 May 2021 / Revised: 7 June 2021 / Accepted: 11 June 2021 / Published: 15 June 2021
(This article belongs to the Section Neurology)
Background and Objectives: Neutrophil-to-lymphocyte ratio (NLR), a very low cost, widely available marker of systemic inflammation, has been proposed as a potential predictor of short-term outcome in patients with intracerebral hemorrhage (ICH). Methods: Patients with ICH admitted to the Neurology Department during a two-year period were screened for inclusion. Based on eligibility criteria, 201 patients were included in the present analysis. Clinical, imaging, and laboratory characteristics were collected in a prespecified manner. Logistic regression models and receiver operating characteristics (ROC) curves were used to assess the performance of NLR assessed at admission (admission NLR) and 72 h later (three-day NLR) in predicting in-hospital death. Results: The median age of the study population was 70 years (IQR: 61–79), median admission NIHSS was 16 (IQR: 6–24), and median hematoma volume was 13.7 mL (IQR: 4.6–35.2 mL). Ninety patients (44.8%) died during hospitalization, and for 35 patients (17.4%) death occurred during the first three days. Several common predictors were significantly associated with in-hospital mortality in univariate analysis, including NLR assessed at admission (OR: 1.11; 95% CI: 1.04–1.18; p = 0.002). However, in multivariate analysis admission, NLR was not an independent predictor of in-hospital mortality (OR: 1.04; 95% CI: 0.9–1.1; p = 0.3). The subgroup analysis of 112 patients who survived the first 72 h of hospitalization showed that three-day NLR (OR: 1.2; 95% CI: 1.09–1.4; p < 0.001) and age (OR: 1.05; 95% CI: 1.02–1.08; p = 0.02) were the only independent predictors of in-hospital mortality. ROC curve analysis yielded an optimal cut-off value of three-day NLR for the prediction of in-hospital mortality of ≥6.3 (AUC = 0.819; 95% CI: 0.735–0.885; p < 0.0001) and Kaplan–Meier analysis proved that ICH patients with three-day NLR ≥6.3 had significantly higher odds of in-hospital death (HR: 7.37; 95% CI: 3.62–15; log-rank test; p < 0.0001). Conclusion: NLR assessed 72 h after admission is an independent predictor of in-hospital mortality in ICH patients and could be widely used in clinical practice to identify the patients at high risk of in-hospital death. Further studies to confirm this finding are needed. View Full-Text
Keywords: intracerebral hemorrhage; neutrophil-to-lymphocyte ratio; in-hospital mortality; outcome intracerebral hemorrhage; neutrophil-to-lymphocyte ratio; in-hospital mortality; outcome
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MDPI and ACS Style

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://0-doi-org.brum.beds.ac.uk/10.3390/medicina57060622

AMA Style

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://0-doi-org.brum.beds.ac.uk/10.3390/medicina57060622

Chicago/Turabian Style

Radu, Răzvan A., Elena O. Terecoasă, Cristina Tiu, Cristina Ghiță, Alina I. Nicula, Andreea N. Marinescu, and Bogdan O. 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://0-doi-org.brum.beds.ac.uk/10.3390/medicina57060622

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