Neutrophil to lymphocyte ratio for traumatic intracerebral hemorrhage [Neurosurgery Wiki]

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====== Neutrophil to lymphocyte ratio for traumatic intracerebral hemorrhage ======
retrospectively reviewed the clinical data of patients with sTBI who were treated in our department between January 2013 and January 2017. NLRs between day 1 and day 12 after admission as well as other related indicators were collected. The relationship between peak NLR and 1-year outcomes was analyzed. Factors associated with larger peak NLR were also explored.

Results: A total of 316 patients were included, and 81.3% (257/316) experienced unfavorable outcomes. Peak NLR was identified as an independent predictor for unfavorable outcomes after sTBI in multivariable logistic regression analysis (odds ratio, 1.086; 95% confidence interval, 1.037-1.137; P < 0.001). Its predictive value was confirmed by receiver operating characteristic analysis (area under curve = 0.775; P < 0.001). The day 1 NLR as well as admission Glasgow Coma Scale score was independently correlated with increased peak NLR.

Conclusion: Peak NLR was associated with the clinical prognosis after sTBI and was a promising predictor for 1-year outcomes
((Chen J, Qu X, Li Z, Zhang D, Hou L. Peak Neutrophil-to-Lymphocyte Ratio Correlates with Clinical Outcomes in Patients with Severe Traumatic Brain Injury. Neurocrit Care. 2019 Apr;30(2):334-339. doi: 10.1007/s12028-018-0622-9. PMID: 30288677.)).
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The [[neutrophil-to-lymphocyte ratio]] (NLR) has been proposed to capture the inflammatory status of patients with various conditions involving the brain. This retrospective study aimed to explore the association between the NLR and the early growth of [[traumatic intracerebral hemorrhage]] (tICH) in patients with [[traumatic brain injury]] (TBI).

A multicentre, observational cohort study was conducted. Patients with cerebral contusion undergoing baseline computed tomography for hematoma volume analysis within 6 h after primary injury and follow-up visits within 48 h were included. Routine blood tests were performed upon admission, and early growth of tICH was assessed. Prediction accuracies of the NLR for the early growth of tICH and subsequent surgical intervention in patients were analyzed.

There were a total of 1077 patients who met the criteria included in the study cohort. Univariate analysis results showed that multiple risk factors were associated with the early growth of tICH and included in the following multivariate analysis models. The multivariate logistic regression analysis results revealed that the NLR was highly associated with the early growth of tICH (p < 0.001) while considering other risk factors in the same model. The prediction accuracy of the NLR for the early growth of tICH in patients is 82%.

Interpretation: The NLR is easily calculated and might predict the early growth of tICH for patients suffering from TBI
((Zhuang D, Sheng J, Peng G, Li T, Cai S, Din F, Li L, Huang M, Tian F, Li K, Wang S, Chen W. Neutrophil to lymphocyte ratio predicts early growth of traumatic Intracerebral hemorrhage. Ann Clin Transl Neurol. 2021 Jun 24. doi: 10.1002/acn3.51409. Epub ahead of print. PMID: 34165245.)).