Prognostic Significance of the Combined Score of Plasma Fibrinogen and Neutrophil-Lymphocyte Ratio in Patients with Spontaneous Intracerebral Hemorrhage

Yang, Wanchun; Yuan, Yunbo; Li, Junhong; Shuai, Yuli; Liao, Xiang; Yu, Zhiyuan; Li, Hao; Zheng, Jun

doi:10.1155/2021/7055101

Cited by 6 publications

(4 citation statements)

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“…To the best of our knowledge, research on the prognostic significance of the F-NLR score in aSAH is limited. Yang et al ( 11 ) had revealed the usefulness of F-NLR scores in ICH, it was an independent risk factor for 3-month functional outcomes. Despite the difference in disease entity, similar result was observed in our study.…”

Section: Discussionmentioning

confidence: 99%

“…Fibrinogen and NLR were classified into high and low groups based on the optimal cutoff values according to the receiver operating characteristic (ROC) curves. F-NLR score was defined as follows: (1) score 0, low fibrinogen and low NLR; (2) score 1, low fibrinogen and high NLR or high fibrinogen and low NLR; and (3) score 2, high fibrinogen and high NLR ( 11 ). Patients were not treated with steroids and received 2.0 g of tranexamic acid intravenously every 12 h after blood sample collection.…”

Section: Methodsmentioning

confidence: 99%

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Prognostic significance of combined score of fibrinogen and neutrophil-lymphocyte ratio for functional outcome in patients with aneurysmal subarachnoid hemorrhage

Hou

Yang

et al. 2022

Front. Neurol.

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ObjectiveTo explore the relationship between fibrinogen and neutrophil to lymphocyte ratio (F-NLR) score and functional outcomes after aneurysmal subarachnoid hemorrhage (aSAH).MethodA retrospective study was conducted that involved all consecutive patients with aSAH admitted to our institution from March 2018 to October 2021. Factors, such as demographics, comorbidities, clinical characteristics, neuroradiological data, and laboratory parameters, were collected from institutional databases. All patients achieved neurological assessment using the modified Rankin Scale (mRS) score 3 months after discharge to clarify the functional outcomes. The results were classified as favorable (mRS score 0–2) and unfavorable (mRS score 3–6). Univariate and multivariable analyses were performed to identify the relevant factors between inflammatory markers and functional outcomes after aSAH. Subsequently, a receiver operating characteristic (ROC) curve analysis was conducted to evaluate the predicting performance of variables. A propensity score match (PSM) was performed to correct imbalances in patients' baseline characteristics.ResultsFinally, 256 patients with aSAH were included in the study cohort. A total of 94 (36.7%) patients had an unfavorable outcome. F-NLR scores were 0 [interquartile range (IQR) 0–1] and 1 (IQR 1–2) in patients with favorable and unfavorable outcomes, respectively (p < 0.001). After adjustment, the F-NLR score on admission remained significantly associated with unfavorable outcomes in patients with aSAH. In the multivariable analysis, the F-NLR score was regarded as an independent risk factor of unfavorable outcomes [odds ratio (OR) 3.113, 95% CI 1.755–5.523, p < 0.001]. In ROC analysis, the optimal cutoff value of the F-NLR score was 0.5 points. Two cohorts (n = 86 in each group) obtained from PSM with low F-NLR scores (0 points) and high F-NLR scores (1–2 points) were used for analysis. A significantly higher unfavorable functional outcome rate was observed in patients with high F-NLR scores (33.7 vs. 9.3%, p < 0.001). The area under the curve (AUC) values of F-NLR scores before and after PSM were 0.767 and 0.712, respectively.ConclusionFibrinogen and neutrophil to lymphocyte ratio score was an independent risk parameter associated with unfavorable functional outcomes at 3 months after aSAH. A higher F-NLR score predicts the occurrence of poor functional outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Prognostic significance of combined score of fibrinogen and neutrophil-lymphocyte ratio for functional outcome in patients with aneurysmal subarachnoid hemorrhage

Hou

Yang

et al. 2022

Front. Neurol.

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“…Yang et al . 46 established F-NLR score with the combination of plasma fibrinogen and NLR, which could predict poor prognosis after ICH. Nevertheless, this score also depended on the cutoff values from a single center and the AUCs of 1-month mortality and 3-month poor outcome were both lower than the inflammatory score (0.809 vs. 0.883; 0.699 vs. 0.857).…”

Section: Discussionmentioning

confidence: 99%

Inflammatory score predicts early hematoma expansion and poor outcomes in patients with intracerebral hemorrhage

Chu

Huang

Zhou³

et al. 2023

International Journal of Surgery

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Background: This study aimed to develop a prediction score named inflammatory score based on proper integration of several inflammatory markers and investigate whether it was associated with hematoma expansion and poor outcomes in patients with intracerebral hemorrhage (ICH). Methods: This study involved a consecutive series of spontaneous ICH patients of two cohorts admitted within 24 hours after symptom onset. Inflammatory score (0–9) was developed with the combination of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, systemic immune-inflammation index, lactate dehydrogenase, and C-reactive protein. The authors investigated the association between inflammatory score and hematoma expansion and poor outcomes by using univariate and multivariate logistic regression analyses. The optimal cutoff point of inflammatory score was determined by receiver operating characteristic analysis in the development cohort and then validated. Results: A total of 301 and 154 ICH patients were enrolled in the development and validation cohorts. Inflammatory score was significantly higher in patients with hematoma expansion and poor outcomes. The multivariate logistic regression analysis revealed inflammatory score was independently associated with hematoma expansion, secondary neurological deterioration within 48 hours, 30-day mortality, and 3-month poor modified Rankin scale (4–6). The diagnostic accuracy of inflammatory score exhibited by area under the curve showed numerically or statistically higher than most of the individual indicators. Moreover, inflammatory score greater than or equal to 5 was selected as the optimal cutoff point, which was further prospectively validated with high diagnostic accuracy. Conclusions: The inflammatory score is a reliable predictor for early hematoma expansion and short-term and long-term poor outcomes with good diagnostic accuracies in ICH patients.

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“…After sICH, neutrophils are the earliest recruited cells in the central nervous system [12]. Neutrophils infiltrate the brain parenchyma, facilitate the hematoma resolution and release multiple inflammatory factors [13].…”

Section: Discussionmentioning

confidence: 99%

Prognostic Significance of Admission Lymphocyte-to-Monocyte Ratio in Patients with Spontaneous Intracerebral Hemorrhage: A Retrospective Study

et al. 2022

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Background Acute spontaneous intracerebral hemorrhage (sICH) is a morbid and deadly form of stroke. The lymphocyte-to-monocyte ratio (LMR) and systemic immune-inflammation index (SII) are two novel markers of systemic inflammation. We aimed at investigating the predictive value of LMR and SII in patients with sICH. Methods We retrospectively evaluated patients who were hospitalized for sICH at the First Affiliated Hospital of Zhengzhou University from September 2019 to July 2020. According to the 3-month modified Rankin Scale (mRS) score, we considered a good prognosis group (mRS: 0–2) and a poor prognosis group (mRS ≥ 3 or death). A logistic regression analysis was used to identify the factors affecting the prognosis at 3 months. Results A total of 171 patients with sICH were enrolled. A lower LMR measured at 24 h of admission was an independent predictor of 3-month prognosis (OR: 0.392, 95% CI 0.281–0.547, p < 0.001). A lower GCS score measured at 24 h after admission was an independent predictor of 3-month prognosis (OR: 0.821, 95% CI 0.747–0.902, p = 0.023). A previous heart disease was an independent predictor of 3-month prognosis (OR: 6.307, 95% CI 1.381–30.196, p = 0.021). SII measured at 24 h of admission was not an independent predictor of 3-month prognosis. Combining the results obtained by each indicator, the final curve showed an AUC of 0.850, indicating a satisfactory predictive performance. The receiver operating characteristic curves showed that the sensitivity of LMR was 93.07% (95% CI 86.2–97.2), while the specificity was 52.86% (95% CI 40.6–64.9). The sensitivity of GCS score was 76.77% (95% CI 67.2–84.7), while the specificity was 60.29% (95% CI 47.7–72.05). The sensitivity of SII was 91.09% (95% CI 83.8–95.8), while the specificity was 37.14% (95% CI 25.9–49.5). The DeLong test showed that the predictive value of LMR was higher than SII (p = 0.0001). Conclusions In patients with sICH, LMR showed an independent predictive value for anticipating 3-month prognosis.

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Prognostic Significance of the Combined Score of Plasma Fibrinogen and Neutrophil-Lymphocyte Ratio in Patients with Spontaneous Intracerebral Hemorrhage

Cited by 6 publications

References 46 publications

Prognostic significance of combined score of fibrinogen and neutrophil-lymphocyte ratio for functional outcome in patients with aneurysmal subarachnoid hemorrhage

Prognostic significance of combined score of fibrinogen and neutrophil-lymphocyte ratio for functional outcome in patients with aneurysmal subarachnoid hemorrhage

Inflammatory score predicts early hematoma expansion and poor outcomes in patients with intracerebral hemorrhage

Prognostic Significance of Admission Lymphocyte-to-Monocyte Ratio in Patients with Spontaneous Intracerebral Hemorrhage: A Retrospective Study

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