• Fan Zhang, Yanming Ren, Wei Fu, Zijia Yang, Dingke Wen, Xin Hu, Chuanyuan Tao, Xi Li, Chao You, Tao Xin, and Mu Yang.
• Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China; Department of Pathology, Case Western Reserve University, Ohio, Cleveland, USA.
• World Neurosurg. 2019 May 1; 125: e651-e657.

BackgroundIt is well established that inflammation plays a critical role in the progression of intracerebral hemorrhage (ICH). Recently the neutrophil-to-lymphocyte ratio (NLR) was identified as a predictor for the short-term outcome in ICH patients. However, the association of NLR with the long-term outcome in patients with ICH remains unknown. Here, we aimed to assess the relationship between NLR and the long-term prognosis in ICH patients.MethodsAll patients with spontaneous ICH who were hospitalized at West China Hospital of Sichuan University from October 2013 to May 2017 were retrospectively enrolled. White blood count, absolute count of neutrophils, and lymphocytes were extracted from electronic medical records, and NLR was calculated according to admission neutrophil count (ANC) and lymphocyte count (ALC). The associations between long-term outcomes and laboratory biomarkers were estimated by multivariable logistic regression analysis. Receiver operating characteristic (ROC) curves were also determined to compare the predictive powers between each inflammatory factor.ResultsA total of 481 ICH patients were included in the study. Of those, 204 presented with unfavorable outcomes, and 142 were dead within 6 months. Age, Glasgow Coma Scale (GCS) scores, WBC, ANC, NLR, hematoma size, and hydrocephalus were independently associated with poor prognosis of ICH. Multiple linear analysis showed GCS, hematoma volume, WBC, ANC, and ALC to be correlated with NLR. Moreover, in comparison with other single laboratory determinations, NLR also showed better predictive capacity for long-term mortality and morbidity, for which the best predictive cutoff values were 9.07 and 8.69, respectively.ConclusionsNLR independently predicts 180-day morbidity and 180-day mortality in patients with spontaneous ICH.Copyright © 2019 Elsevier Inc. All rights reserved.

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