Association Between High Preoperative White Blood Cell-to-Hemoglobin Ratio and Postoperative Symptomatic Cerebral Vasospasm in Patients With Aneurysmal Subarachnoid Hemorrhage.

IF 2.3 2区医学 Q2 ANESTHESIOLOGY Journal of neurosurgical anesthesiology Pub Date : 2024-06-17 DOI:10.1097/ANA.0000000000000977

Kyung Won Shin, Eun Bi Park, Woo-Young Jo, Hyung-Chul Lee, Hee-Pyoung Park, Hyongmin Oh

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Abstract

Background: Cerebral vasospasm after aneurysmal subarachnoid hemorrhage (ASAH) is a serious complication and has a strong relationship with systemic inflammatory responses. Given previously reported relationships between leukocytosis and anemia with ASAH-related cerebral vasospasm, this study examined the association between the preoperative white blood cell-to-hemoglobin ratio (WHR) and postoperative symptomatic cerebral vasospasm (SCV) in patients with ASAH.

Methods: Demographic, preoperative (comorbidities, ASAH characteristics, laboratory findings), intraoperative (operation and anesthesia), and postoperative (SCV, other neurological complications, clinical course) data were retrospectively analyzed in patients with ASAH who underwent surgical or endovascular treatment of the culprit aneurysm. Patients were divided into high-WHR (n=286) and low-WHR (n=257) groups based on the optimal cutoff value of preoperative WHR (0.74), and stabilized inverse probability weighting was performed between the 2 groups. The predictive power of the WHR and other preoperative systemic inflammatory indices (neutrophil-to-albumin, neutrophil-to-lymphocyte, platelet-to-lymphocyte, platelet-to-neutrophil, platelet-to-white blood cell ratios, and systemic immune-inflammation index) for postoperative SCV was evaluated.

Results: Postoperative SCV was more frequent in the high-WHR group than in the low-WHR group before (33.2% vs. 12.8%; P<0.001) and after (29.4% vs. 19.1%; P=0.005) inverse probability weighting. Before weighting, the predictive power for postoperative SCV was the highest for the WHR among the preoperative systematic inflammatory indices investigated (area under receiver operating characteristics curve 0.66, P<0.001). After weighting, preoperative WHR ≥0.74 was independently associated with postoperative SCV (odds ratio 1.76; P=0.006).

Conclusions: High preoperative WHR was an independent predictor of postoperative SCV in patients with ASAH.

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动脉瘤性蛛网膜下腔出血患者术前高白细胞血红蛋白比值与术后症状性脑血管痉挛之间的关系

背景：动脉瘤性蛛网膜下腔出血（ASAH）后脑血管痉挛是一种严重的并发症，与全身炎症反应关系密切。鉴于之前报道的白细胞增多和贫血与 ASAH 相关脑血管痉挛之间的关系，本研究探讨了 ASAH 患者术前白细胞与血红蛋白比值（WHR）与术后症状性脑血管痉挛（SCV）之间的关系：对接受手术或血管内治疗动脉瘤的ASAH患者的人口统计学、术前（合并症、ASAH特征、实验室检查结果）、术中（手术和麻醉）和术后（SCV、其他神经系统并发症、临床过程）数据进行回顾性分析。根据术前WHR的最佳临界值（0.74），将患者分为高WHR组（286人）和低WHR组（257人），并在两组之间进行稳定的反概率加权。评估了WHR和其他术前全身炎症指数（中性粒细胞与白蛋白比、中性粒细胞与淋巴细胞比、血小板与淋巴细胞比、血小板与中性粒细胞比、血小板与白细胞比和全身免疫炎症指数）对术后SCV的预测能力：结果：高WHR组术后SCV的发生率高于低WHR组（33.2%对12.8%；PC结论：术前高WHR是导致术后SCV的一个因素：术前高WHR是ASAH患者术后SCV的独立预测因素。

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来源期刊

Journal of neurosurgical anesthesiology 医学-临床神经学

CiteScore

6.20

自引率

10.80%

发文量

119

审稿时长

>12 weeks

期刊介绍： The Journal of Neurosurgical Anesthesiology (JNA) is a peer-reviewed publication directed to an audience of neuroanesthesiologists, neurosurgeons, neurosurgical monitoring specialists, neurosurgical support staff, and Neurosurgical Intensive Care Unit personnel. The journal publishes original peer-reviewed studies in the form of Clinical Investigations, Laboratory Investigations, Clinical Reports, Review Articles, Journal Club synopses of current literature from related journals, presentation of Points of View on controversial issues, Book Reviews, Correspondence, and Abstracts from affiliated neuroanesthesiology societies. JNA is the Official Journal of the Society for Neuroscience in Anesthesiology and Critical Care, the Neuroanaesthesia and Critical Care Society of Great Britain and Ireland, the Association de Neuro-Anesthésiologie Réanimation de langue Française, the Wissenschaftlicher Arbeitskreis Neuroanästhesie der Deutschen Gesellschaft fur Anästhesiologie und Intensivmedizen, the Arbeitsgemeinschaft Deutschsprachiger Neuroanästhesisten und Neuro-Intensivmediziner, the Korean Society of Neuroanesthesia, the Japanese Society of Neuroanesthesia and Critical Care, the Neuroanesthesiology Chapter of the Colegio Mexicano de Anesthesiología, the Indian Society of Neuroanesthesiology and Critical Care, and the Thai Society for Neuroanesthesia.