Application value of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in predicting stress ulcer after acute cerebral hemorrhage surgery

Abstract

Objective

The Platelet-to-Lymphocyte Ratio (PLR) and Neutrophil-to-Lymphocyte Ratio (NLR) are established biomarkers that are associated with the severity, progression, and fatality of diseases. This study aimed to determine their predictive value for the occurrence of stress ulcers (SU) following surgery for acute cerebral hemorrhage.

Methods

Retrospective data from 210 patients with acute cerebral hemorrhage hospitalized between June 2020 and March 2023 were analyzed. Patients were categorized into two groups based on the occurrence of SU post-surgery: the SU group (42 patients) and the non-SU group (168 patients). Clinical characteristics of both groups were compared, and a multivariate logistic regression was conducted to identify independent risk factors for SU. The study evaluated the predictive value of NLR and PLR, individually and in combination, for predicting SU using Receiver Operating Characteristic (ROC) curves.

Results

We observed significant differences between the SU and non-SU groups in several parameters, including GCS score, absolute neutrophils, NLR, PLR, postoperative tracheotomy, and intracranial infection (P < 0.05). Our multivariate logistic regression analysis identified four independent risk factors for SU in patients undergoing surgery for acute cerebral hemorrhage: GCS score, NLR, PLR, and fasting blood glucose (P < 0.05). Furthermore, ROC analysis demonstrated that the combination of NLR and PLR exhibited the highest AUC, sensitivity, and specificity in predicting SU following surgery for acute cerebral hemorrhage (P < 0.001), with values of 0.864 (95 % CI: 0.776–0.953), 0.778 (95 % CI: 0.658–0.899), and 0.941 (95 % CI: 0.889–0.993) respectively.

Conclusion

This study highlighted the combined application of PLR and NLR as a significant predictor of SU in patients post-acute cerebral hemorrhage surgery.