707 Associations Between Inflammatory Markers and Outcomes in SICH

Abstract

INTRODUCTION: Studies have shown that higher neutrophil-lymphocyte ratio (NLR) significantly associated with poorer outcomes. However, most studies evaluated ischemic stroke and did not look at other markers such as platelet-lymphocyte ratio (PLR), platelet-white cell ratio (PWR) and platelet-neutrophil ratio (PNR). Wang et al demonstrated NLR had no correlation with mortality in spontaneous intracerebral hemorrhage (SICH). METHODS: We included 1001 patients with SICH diagnosed on computed tomography of the brain from January 2014 to December 2021. Good functional outcomes were defined as modified Rankin Scale (mRS) 0 to 2 while bad outcomes were defined as 3 to 6. Logistic regression was used to adjust for demographics (Model 1), cardiovascular risk factors (Model 2), bleed characteristics (Model 3) and baseline GCS (Model 4). Statistical analysis was done with R Studio. RESULTS: Logistic regression showed that NLR (OR: 1.03, 95% CI: 1.00-1.06, p < .05), PWR (OR: 0.98, 95% CI: 0.96-1.00, p < .05) and PNR (OR: 0.98, 95% CI: 0.97-0.99, p < .01) were significantly associated with 30-day mortality even after adjusting for confounders. However, PNR became non-significant after adjusting for bleed characteristics and GCS. When comparing 90-day functional outcome, only PWR (OR: 1.03, 95% CI: 1.01-1.04, p < .01) and PNR (OR: 1.01, 95% CI: 1.00-1.01, p < .05) demonstrated significant association even after adjusting for demographics and cardiovascular risk factors. CONCLUSIONS: In conclusion, NLR and PWR were independently and statistically associated with 30-day mortality. Further research on the value of ratios of inflammatory cells in prognosticating outcomes may help improve patient management.