Neutrophil-lymphocyte ratio: A simple and accurate biomarker for the prognosis of patients with intracerebral bleeding, a study of 115 cases.

Abstract

Background: Stroke is high in both mortality and disability; this makes stroke the world's second leading cause of death and the number one cause of long-term impairment. Surprisingly, intracerebral hemorrhage (ICH), the second largest type of stroke, is deadlier than ischemic strokes , with a high mortality rate and lack of effective treatment for ICH. This case report aims to identify and collect the various factors that increase the mortality rate of patients with ICH.

Methods: A retrospective review was done on 115 patients who experienced ICH at neurosurgical unit care between 2021 and 2024. Data were collected from medical record post admission reports. The study concentrated on factors such as the initial Glasgow coma scale (GCS) score, the volume of intracerebral bleeding, the ratio of neutrophils to lymphocytes, leukocyte count, and the administration of neuroprotective medications. We first ran univariate tests. Next, to evaluate the relationship between each component and patient mortality, we performed bivariate analyses with Spearman's correlation test. To determine the predictor factor from all the various variables that have been evaluated, we use multivariate analysis with logistic regression.

Results: Univariate analysis results show that ICH often occurs at the age of 41-50 years in males. Meanwhile, most of the patients who died were men aged 51-60 years. The results of the bivariate analysis showed that each predictor had a significant relationship with mortality. GCS has a negative relationship with mortality (-0.633 with P < 0.001). The neutrophil-to-lymphocyte ratio (NLR) (0.418), leukocyte count (0.527), and ICH blood volume (0.671) had a positive effect on ICH mortality. Multivariate analysis with logistic regression demonstrated that all predictor factors had a significant impact (P < 0.05) on mortality patients with hemorrhagic stroke. The most common neuroprotective therapy used in hemorrhagic stroke is the combination of citicoline and mecobalamin. The co-administration of citicoline and mecobalamin showed the highest number of survivors and deaths, indicating that no effective therapy for ICH has been found among all the neuroprotectants administered.

Conclusion: This study showed that GCS, ICH volume, leukocyte count, and NLR are predictors of mortality in ICH patients. At present, no ICH therapy can reduce complications and improve the physical and mental condition of ICH patients. Therefore, further research is needed to find an effective therapy for ICH.