Temporal averaging angiographic reconstructions from whole-brain CT perfusion for the detection of vasospasm

CLR (C-Reactive Protein to Lymphocyte Ratio) Served as a Promising Predictive Biomarker for Cerebral Vasospasm in Aneurysmal Subarachnoid Hemorrhage (aSAH): A Retrospective Cohort Study

“…A total of 117 (70.5%) patients were diagnosed with hypertension. The median admission WFNS grade was 2 (IQR, 1-5) and the median GCS score was 13 (IQR,(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Additionally, the median of CRP, WBC, platelet, neutrophil, lymphocyte, monocyte, CLR, NLR, PLR, and MLR in the cohort were 0.50 (IQR, 0.20-1.40) mg/dL, 13.35 (IQR, 10.58-15.90) × 10 9 /L, 230.50 (IQR, 196.75-278.25) × 10 9 /L, 11.17 (IQR, 8.52-14.00) × 10 9 /L, 1.05 (IQR, 0.74-1.60) × 10 9 /L, 0.78 (IQR, 0.50-1.00) × 10 9 /L, 0.50 (IQR, 0.17-1.56) mg × 10 −6 , 11.00 (IQR, 6.24-16.74), 218.87 (IQR, 143.57-323.11), and 0.63 (IQR, 0.43-0.90), respectively.…”

“…The incidence of DCI (DCI: CLR < 0.757 mg × 10 −6 20/100 [20.0%] vs. CLR ≥ 0.757 mg × 10 −6 33/66 [50.0%]; p < 0.001) and CH (CH: CLR < 0.757 mg × 10 −6 45/100 [45.0%] vs. CLR ≥ 0.757 mg × 10 −6 43/66 [65.2%]; p = 0.011) in patients with CLR < 0.757 mg × 10 −6 were significantly lower than those in patients with CLR ≥ 0.757 mg × 10 −6 . The outcome (median [IQR] 6 months mRS 2 [1][2][3][4][5] vs. 4 [1][2][3][4][5][6]; p = 0.003) in patients with CLR < 0.757 mg × 10 −6 was better than that in patients with CLR ≥ 0.757 mg × 10 −6 . J. Clin.…”

“…CVS is one of the major causes of morbidity and mortality after aSAH in patients surviving from initial aneurysmal rupture. CVS can be diagnosed through transcranial Doppler ultrasonography (TCD), digital subtraction angiography (DSA), or computed tomography angiography (CTA)/perfusion (CTP) [6]. For survivors of aSAH, DCI serves as an important modifiable prognostic factor and occurs mostly on the fourth day or later.…”

“…Univariate analysis revealed that the on-admission serum levels of CRP (median [IQR] CRP 1.95 [0.80-3.10] mg/dL vs. 0.30 [0.18-0.80] mg/dL; p < 0.001), WBC (median [IQR] WBC 14.05[11.68-18.33] × 10 9 /L vs. 12.60[10.10-15.70] × 10 9 /L; p = 0.040), neutrophil (median [IQR] neutrophil 11.95[10.05-15.95] × 10 9 /L vs. 10.49[7.88-13.49] × 10 9 /L; p = 0.007), and CLR (median [IQR] CLR 1.83 [0.77-4.46] mg × 10 −6 vs. 0.30 [0.12-0.76] mg × 10 −6 ; × 10 9 /L vs. 1.17 [0.80-1.62] × 10 9 /L; p = 0.010) in patients with CVS was significantly less than that in patients without CVS. The patients without CVS had favorable admission status, meaning a lower WFNS grade (median [IQR] WFNS grade 2[1][2][3][4][5] vs. 3[2][3][4][5]; p = 0.018) and higher GCS score (median [IQR] GCS score 14[5][6][7][8][9][10][11][12][13][14][15] vs. 11[3][4][5][6][7][8][9][10][11][12][13][14]; p = 0.016) than those in patients with CVS. The patients without CVS had better neurological functional outcome (median [IQR] 6 months mRS 2[1][2][3][4][5] vs. 5 [2-6]; p < 0.001) and less incidence of neurological complications including DCI (number [%] DCI 26 [22.0%] vs. 27 [56.3%]; p < 0.001), CH (number [%] CH 53 [44.9%] vs. 35 [72.9%]; p = 0.001), and seizures (number [%] seizures 12 [10.2%] vs. 11 [22.9%]; p = 0.031) than those in patients with CVS.…”