Platelet-to-Lymphocyte Ratio as a New Predictive Index of Neurological Outcomes in Patients with Acute Intracranial Hemorrhage: A Retrospective Study
Weimin Zhang, Yanfei Shen
Intensive Care Unit, Dongyang People's Hospital, Dongyang, Zhejiang, China (mainland)
Med Sci Monit 2018; 24: CLR4413-4420
Available online: 2018-06-27
Systemic inflammation plays a critical role in the pathophysiological process of intracranial hemorrhage (ICH). Recently, the platelet-to-lymphocyte ratio (PLR) has become a research focus that indicates inflammation in various diseases. Thus, this study aimed to investigate the predictive value of PLR in patients with acute ICH.
MATERIAL AND METHODS: This study was performed in a single teaching hospital. Glasgow coma scale at hospital discharge (GCSdis) and modified Rankin score (MRS) at 6 months were recorded as short-term and long-term neurological outcomes. Ordered and binary logistic regression methods were used to explore the associations.
RESULTS: Finally, data on 183 ICH patients were included. A knot of PLR around 100 was detected and applied in the extended ordered logistic regression models. For PLR >100, PLR on ICU admission was significantly associated with worse GCSdis (from Model 1: OR: 1.004, 95% CI 1.001–1.007 to Model 4: OR: 1.006, 95% CI 1.002–1.009) while the PLR on Emergency Department (ED) admission was insignificant. For PLR ≤100, neither the PLR on ICU or ED admission was associated with GCSdis level. In the quartile grouping analysis, PLR Q2 was used as a reference level. Both Q3 and Q4 on ICU admission were significantly associated with lower GCSdis level (OR, 3.30; 95%CI 1.38–7.88; and OR, 3.79; 95%CI 1.54–9.33, respectively), while Q1 was insignificant. All 4 quartiles of PLR on ED admission were not associated with GCSdis.
CONCLUSIONS: Only higher PLR value on ICU admission but not on ED admission was associated with worse GCSdis.
Keywords: Glasgow Coma Scale, Intracranial Hemorrhages, Lymphocyte Count, Platelet Count