Effects of C-reactive protein and neutrophil to lymphocyte ratio on cognitive dysfunction after basal ganglia hemorrhage

Abstract

Objective To investigate the effects of C-reactive protein(CRP) and the neutrophils to lymphocytes ratio(NLR) on cognitive dysfunction after spontaneous basal ganglia hemorrhage. Methods 263 patients with spontaneous basal ganglia cerebral hemorrhage admitted to our hospital from September 2021 to January 2024 were selected as the study objects.Cognitive function was assessed by the Montreal Cognitive Assessment Scale (MoCA) after six months and divided into cognitive dysfunction group and normal cognitive function group.The level of CRP and NLR were compared between the two groups.The correlation between the level and degree of cognitive impairment was analyzed, and the correlation factors of cognitive impairment in spontaneous basal ganglia hemorrhage were studied by single factor, ROC curve and Logistic regression analysis. Results Among 263 patients, 120 (45.63%) had cognitive impairment after basal ganglia hemorrhage.The CRP and NLR in the cognitive dysfunction group were significantly higher than those in the normal cognitive function group (P < 0.05).ROC curve analysis showed that National Institute of Health Stroke Scale(NIHSS) score, amount of bleeding, white blood cells(WBC), absolute neutrophil count(ANC), NLR and CRP were associated with cognitive impairment after spontaneous basal ganglia hemorrhage.The area under the curve(AUC) of NLR was 83.1%, and the CRP was 77.4%.The NLR and CRP were the optimal predictive variables,The optimal prediction thresholds of ROC analysis were 3.88 and 3.34.Logistic regression analysis found that after adjusting for confounding factors, NLR and CRP were still independently associated with cognitive impairment after basal ganglia hemorrhage (OR = 1.38,95%CI: 1.15–1.64, P < 0.001) and (OR = 1.42,95%CI: 1.19–1.85, P < 0.001). Conclusion The NLR and CRP in the acute stage of spontaneous basal ganglia hemorrhage were independently associated with cognitive dysfunction after 6 months, suggesting that NLR and CRP may be the important biomarkers for predicting cognitive dysfunction after spontaneous basal ganglia hemorrhage.