Neutrophil-to-Lymphocyte Ratio on Admission Predicts Gastrointestinal Bleeding in Acute Basal Ganglia Hemorrhage

Overview

Journal J Clin Lab Anal

Publisher Wiley

Specialties Biomedical Engineering
Biotechnology
Pathology

Date 2022 Sep 1

PMID 36045605

Authors

Xuewei Jiang

Liangliang Zhou

Yinuo Chen

Yuqing Tang

Xiaodong Jiang

Affiliations

Soon will be listed here.

Abstract

Background: Gastrointestinal bleeding (GIB) is a potential contributing factor for poor prognosis of spontaneous basal ganglia hemorrhage (BGH). This study aimed to investigate the predictive value of new inflammatory biomarkers including neutrophil to lymphocytes (NLR) on admission and construct a nomogram for rapidly predicting GIB in acute BGH.

Methods: The retrospective study included all patients with acute BGH admitted from the emergency department in Huashan Hospital from July 2017 to January 2019. Multivariate analysis was conducted to evaluate the correlation between factors within 24 h and the occurrence of GIB within 7 days after BGH. The receiver operating characteristic (ROC) curve was performed to estimate the prediction ability of inflammatory biomarkers. A nomogram based on significant predictors was validated by ROC curve and calibration curve.

Results: A total of 122 patients were enrolled in this study, and the incidence of GIB was 23.0%. Patients with GIB had larger hematoma volume (≥30 ml), lower Glasgow Coma Scale (GCS) score (≤8) and increased inflammatory biomarkers on admission. ROC curve revealed that NLR had a high predictive value to the complication (area under the curve = 0.87). According to multivariate analysis, NLR, GCS score, and hematoma volume were main factors for nomogram, with good calibration and discrimination.

Conclusions: Neutrophil-to-lymphocyte ratio and GCS score within 24 h after the onset of acute BGH are the independent risk factors for GIB. The nomogram developed by these predictors may assist surgeons in rapidly assessing and preventing of GIB for BGH patients in earlier stage.

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References

Rendevski V, Aleksovski B, Rendevska A, Hadzi-Petrushev N, Manusheva N, Shuntov B . Inflammatory and oxidative stress markers in intracerebral hemorrhage: Relevance as prognostic markers for quantification of the edema volume. Brain Pathol. 2022; 33(2):e13106. PMC: 10041164. DOI: 10.1111/bpa.13106. View

Khalid A, Ali Jaffar M, Khan T, Lail R, Ali S, Aktas G . Hematological and biochemical parameters as diagnostic and prognostic markers in SARS-COV-2 infected patients of Pakistan: a retrospective comparative analysis. Hematology. 2021; 26(1):529-542. DOI: 10.1080/16078454.2021.1950898. View

Tschoe C, Bushnell C, Duncan P, Alexander-Miller M, Wolfe S . Neuroinflammation after Intracerebral Hemorrhage and Potential Therapeutic Targets. J Stroke. 2020; 22(1):29-46. PMC: 7005353. DOI: 10.5853/jos.2019.02236. View

Ali D, Barra M, Blunck J, Brophy G, Brown C, Caylor M . Stress-Related Gastrointestinal Bleeding in Patients with Aneurysmal Subarachnoid Hemorrhage: A Multicenter Retrospective Observational Study. Neurocrit Care. 2020; 35(1):39-45. DOI: 10.1007/s12028-020-01137-5. View

Bilgin S, Aktas G, Kocak M, Atak B, Kurtkulagi O, Duman T . Association between novel inflammatory markers derived from hemogram indices and metabolic parameters in type 2 diabetic men. Aging Male. 2019; 23(5):923-927. DOI: 10.1080/13685538.2019.1632283. View

Melmed K, Boehme A, Ironside N, Murthy S, Park S, Agarwal S . Respiratory and Blood Stream Infections are Associated with Subsequent Venous Thromboembolism After Primary Intracerebral Hemorrhage. Neurocrit Care. 2020; 34(1):85-91. PMC: 7223996. DOI: 10.1007/s12028-020-00974-8. View

Cordonnier C, Demchuk A, Ziai W, Anderson C . Intracerebral haemorrhage: current approaches to acute management. Lancet. 2018; 392(10154):1257-1268. DOI: 10.1016/S0140-6736(18)31878-6. View

Yu X, Zhou G, Shao B, Zhou H, Xu C, Yan F . Gut Microbiota Dysbiosis Induced by Intracerebral Hemorrhage Aggravates Neuroinflammation in Mice. Front Microbiol. 2021; 12:647304. PMC: 8137318. DOI: 10.3389/fmicb.2021.647304. View

Laiwattana D, Sangsawang B, Sangsawang N . Primary Multiple Simultaneous Intracerebral Hemorrhages between 1950 and 2013: Analysis of Data on Age, Sex and Outcome. Cerebrovasc Dis Extra. 2014; 4(2):102-14. PMC: 4049014. DOI: 10.1159/000362111. View

10.

Saand A, Yu F, Chen J, Chou S . Systemic inflammation in hemorrhagic strokes - A novel neurological sign and therapeutic target?. J Cereb Blood Flow Metab. 2019; 39(6):959-988. PMC: 6547186. DOI: 10.1177/0271678X19841443. View

11.

Hagen M, Sembill J, Sprugel M, Gerner S, Madzar D, Lucking H . Systemic inflammatory response syndrome and long-term outcome after intracerebral hemorrhage. Neurol Neuroimmunol Neuroinflamm. 2019; 6(5):e588. PMC: 6624147. DOI: 10.1212/NXI.0000000000000588. View

12.

Switonska M, Piekus-Slomka N, Slomka A, Sokal P, Zekanowska E, Lattanzi S . Neutrophil-to-Lymphocyte Ratio and Symptomatic Hemorrhagic Transformation in Ischemic Stroke Patients Undergoing Revascularization. Brain Sci. 2020; 10(11). PMC: 7690817. DOI: 10.3390/brainsci10110771. View

13.

Chen W, Zhao J, Li X, Wang X, Chen J, Zhang T . Using Electronic Medical Records of Nursing Care to Characterize Constipation in Patients with Intracerebral Hemorrhage. Cerebrovasc Dis. 2021; 50(5):535-542. DOI: 10.1159/000515706. View

14.

Zou Y, Zhang W, Huang C, Zhu Y . Clinical significance of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in acute cerebral hemorrhage with gastrointestinal hemorrhage, and logistic regression analysis of risk factors. Exp Ther Med. 2019; 18(3):1533-1538. PMC: 6676203. DOI: 10.3892/etm.2019.7778. View

15.

Aktas G . Hematological predictors of novel Coronavirus infection. Rev Assoc Med Bras (1992). 2021; 67Suppl 1(Suppl 1):1-2. DOI: 10.1590/1806-9282.67.Suppl1.20200678. View

16.

Lattanzi S, Cagnetti C, Rinaldi C, Angelocola S, Provinciali L, Silvestrini M . Neutrophil-to-lymphocyte ratio improves outcome prediction of acute intracerebral hemorrhage. J Neurol Sci. 2018; 387:98-102. DOI: 10.1016/j.jns.2018.01.038. View

17.

Cheng Y, Zan J, Song Y, Yang G, Shang H, Zhao W . Evaluation of intestinal injury, inflammatory response and oxidative stress following intracerebral hemorrhage in mice. Int J Mol Med. 2018; 42(4):2120-2128. DOI: 10.3892/ijmm.2018.3755. View

18.

Balachandran V, Gonen M, Smith J, DeMatteo R . Nomograms in oncology: more than meets the eye. Lancet Oncol. 2015; 16(4):e173-80. PMC: 4465353. DOI: 10.1016/S1470-2045(14)71116-7. View

19.

Xing Y, An Z, Zhang X, Yu N, Zhao W, Ning X . Sex Differences in the Clinical Features, Risk Factors, and Outcomes of Intracerebral Hemorrhage: a Large Hospital-based Stroke Registry in China. Sci Rep. 2017; 7(1):286. PMC: 5428271. DOI: 10.1038/s41598-017-00383-6. View

20.

Hotchkiss R, Moldawer L, Opal S, Reinhart K, Turnbull I, Vincent J . Sepsis and septic shock. Nat Rev Dis Primers. 2017; 2:16045. PMC: 5538252. DOI: 10.1038/nrdp.2016.45. View