TY - JOUR
TI - Admission Neutrophil to Lymphocyte Ratio for Predicting Outcome in
Subarachnoid Hemorrhage
AU - Chang, Jason J.
AU - Dowlati, Ehsan
AU - Triano, Matthew
AU - Kalegha,
AU - Enite
AU - Krishnan, Rashi
AU - Kasturiarachi, Brittany M. and
AU - Gachechiladze, Leila
AU - Pandhi, Abhi
AU - Themistocleous, Marios and
AU - Katsanos, Aristeidis H.
AU - Felbaum, Daniel R.
AU - Mai, Jeffrey C. and
AU - Armonda, Rocco A.
AU - Aulisi, Edward F.
AU - Elijovich, Lucas
AU - Arthur,
AU - Adam S.
AU - Tsivgoulis, Georgios
AU - Goyal, Nitin
JO - Journal of Stroke and Cerebrovascular Diseases
PY - 2021
VL - 30
TODO - 9
SP - null
PB - Elsevier
SN - 1052-3057
TODO - 10.1016/j.jstrokecerebrovasdis.2021.105936
TODO - Subarachnoid hemorrhage; Aneurysmal subarachnoid hemorrhage;  
Inflammation; Neutrophil-to-lymphocyte ratio; Outcome; Delayed cerebral
ischemia
TODO - Purpose: We sought to evaluate the relationship between admission
neutrophil-to-lymphocyte ratio (NLR) and functional outcome in
aneurysmal subarachnoid hemorrhage (aSAH) patients. Material and
methods: Consecutive patients with aSAH were treated at two tertiary
stroke centers during a five-year period. Functional outcome was defined
as discharge modified Rankin score dichotomized at scores 0-2 (good) vs.
3-6 (poor). Results: 474 aSAH patients were evaluated with a mean NLR
8.6 (SD 8.3). In multivariable logistic regression analysis, poor
functional outcome was independently associated with higher NLR, older
age, poorer clinical status on admission, prehospital statin use, and
vasospasm. Increasing NLR analyzed as a continuous variable was
independently associated with higher odds of poor functional outcome (OR
1.03, 95%CI 1.001.07, p=0.05) after adjustment for potential
confounders. When dichotomized using ROC curve analysis, a threshold NLR
value of greater than 6.48 was independently associated with higher odds
of poor functional outcome (OR 1.71, 95%CI 1.07-2.74, p=0.03) after
adjustment for potential confounders. Conclusions: Higher admission NLR
is an independent predictor for poor functional outcome at discharge in
aSAH patients. The evaluation of anti-inflammatory targets in the future
may allow for improved functional outcome after aSAH.
ER -