Clinical Study Of Neutrophil-to-lymphocyte Ratio On The Outcome Of Patients With Intracerebral Hemorrhage In Basal Ganglia

Objective:Neutrophil-to-lymphocyte ratio(NLR)are widely used clinical serological indexes.Previous studies have suggested that NLR is a potential predictor of short-term prognosis in patients with intracerebral hemorrhage(ICH).The purpose of this study was to investigate the effect of elevated NLR on the clinical prognosis of patients with cerebral basal ganglia hemorrhage.Methods:According to the inclusion and exclusion criteria,this study retrospectively included patients with spontaneous cerebral basal ganglia hemorrhage in the Department of Emergency Neurology,affiliated Hospital of Guizhou Medical University.According to the amount of cerebral hemorrhage,the patients were divided into small,medium and large cerebral hemorrhage groups.Based on the Modified Rankin Scale(m RS)at discharge,subjects were classified as having a good or poor prognosis group.Laboratory indicators such as White blood cell(WBC),Absolute neutrophil cell(ANC)and Absolute lymphocyte cell(ALC),blood glucose level(BGL)were collected.NLR values were calculated,and the patients were divided into NLR elevated group and NLR normal group by NLR value.SPSS25.0was used for all data analysis,and P < 0.05 was statistically significant.Results:A total of 275 patients with basal ganglia cerebral hemorrhage admitted to the Affiliated Hospital of Guizhou Medical University from January 2018 to October2021 were included.There were 108 patients in the small hematoma group,including32 patients in the elevated NLR group and 76 patients in the normal NLR group.Amount of hematoma group of 114 people,including 63 NLR rise group,NLR 51 normal group.There were 53 patients in the massive hematoma group,30 patients in the elevated NLR group and 23 patients in the normal NLR group.In the small hematoma group,there were significant differences in GCS and NIHSS between the elevated NLR group and the normal NLR group at admission;61.11% of patients with poor outcome were from the elevated NLR group,and only38.89% were from the normal NLR group;Elevated NLR was an independent predictor of poor functional outcome in patients with minor bleeding,and its sensitivity,specificity,positive predictive value,and negative predictive value were0.611,0.767,0.831,and 0.547 for predicting poor patient outcomes,respectively.In the moderate-volume hematoma group,the NLR-elevated group and the NLR-normal group had no statistically significant prognosis;univariate analysis found that the amount of intracerebral hemorrhage,NIHSS on admission,GCS,WBC,ANC,NLR,and BGL on admission were all statistically significant;The final results showed that NLR had an independent predictive effect on adverse functional outcomes in patients with moderate intracerebral hemorrhage,with a sensitivity and specificity of 0.424 and 0.812,respectively,with a cut-off value of 11.76.In the massive hematoma group,there was no significant difference in prognosis between the elevated NLR group and the normal NLR group.Univariate analysis showed that there was no statistical significance in NLR between the two groups.There was statistical significance in the volume of cerebral hemorrhage and BGL in the good prognosis group and the poor prognosis group.ROC curve confirmed that the volume of cerebral hemorrhage and BGL had independent predictive factors for the adverse functional outcome of patients with massive cerebral hemorrhage.The sensitivity and specificity of cerebral hemorrhage volume were 0.659 and 0.75 respectively,and the sensitivity and specificity were 0.659 and 0.833 respectively.Conclusions:This study systematically investigated the effect of NLR on the adverse outcomes of ICH patients with different hematoma volumes in the basal ganglia region at discharge.The main findings are:(1)in the small-volume hematoma group,elevated NLR(NLR>7.35)has an independent predictive effect on the short-term poor outcomes of ICH patients;(2)in the moderate-volume hematoma group,when NLR>11.76 can independently predict Poor prognosis in patients with basal ganglia hemorrhage;(3)NLR is not an independent risk factor for poor outcomes in patients with basal ganglia hemorrhage in massive hematomas.