Neutrophil to lymphocyte ratio is a prognosis factor for post-operative pneumonia in aneurysmal subarachnoid hemorrhage patients.
Neutrophil to lymphocyte ratio is a prognosis factor for post-operative pneumonia in aneurysmal subarachnoid hemorrhage patients.
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DOI：
10.1097/cm9.0000000000001304
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发表时间：
2020-12-24
影响因子：
6.1
通讯作者：
Kang DZ
中科院分区：
文献类型：
--
作者：
Chen Y;Lian BQ;Peng L;Ding CY;Lin YX;Yu LH;Wang DL;Kang DZ
尽管已经研究了动脉瘤夹闭或弹簧圈栓塞术后肺炎（术后肺炎[POP]）的各种风险因素，但aSAH后POP的预测模型仍未得到很好的建立。因此，本研究的目的是评估使用入院中性粒细胞与淋巴细胞比率（NLR）预测aSAH患者发生POP的可行性。我们评估了711例aSAH患者，他们参加了一项前瞻性观察性研究，并收集了入院时血细胞计数数据。我们分析了这些患者的人口统计学和基线变量，并使用考克斯回归分析了这些因素与POP的相关性。在筛选出与POP相关的因素后，进一步评估这些因素对POP的预测价值。该队列中219例患者（30.4%）发生POP。POP组NLR明显高于非POP组（14.11 ± 8.90 vs.8.80 ± 5.82，P <0.001）。 多变量分析显示，在调整可能的混杂因素（包括年龄、世界神经外科学会联合会（WFNS）分级、血管内治疗和呼吸机使用）后，NLR仍然是与aSAH后POP独立相关的重要因素。WFNS分级与NLR结合后NLR的预测价值显著提高（NLR vs. WFNS分级× NLR，P = 0.011）。 无论WNFS分级是好还是差，NLR >10的患者的POP生存率明显低于NLR ≤10的患者。入院时的NLR可能有助于aSAH患者POP的预测。
Although a variety of risk factors of pneumonia after clipping or coiling of the aneurysm (post-operative pneumonia [POP]) in patients with aneurysmal subarachnoid hemorrhage (aSAH) have been studied, the predictive model of POP after aSAH has still not been well established. Thus, the aim of this study was to assess the feasibility of using admission neutrophil to lymphocyte ratio (NLR) to predict the occurrence of POP in aSAH patients. We evaluated 711 aSAH patients who were enrolled in a prospective observational study and collected admission blood cell counts data. We analyzed available demographics and baseline variables for these patients and analyzed the correlation of these factors with POP using Cox regression. After screening out the prognosis-related factors, the predictive value of these factors for POP was further assessed. POP occurred in 219 patients (30.4%) in this cohort. Patients with POP had significantly higher NLR than those without (14.11 ± 8.90 vs. 8.80 ± 5.82, P < 0.001). Multivariate analysis revealed that NLR remained a significant factor independently associated with POP following aSAH after adjusting for possible confounding factors, including the age, World Federation of Neurosurgical Societies (WFNS) grade, endovascular treatment, and ventilator use. And the predictive value of NLR was significantly increased after WFNS grade was combined with NLR (NLR vs. WFNS grade × NLR, P = 0.011). Regardless of good or poor WNFS grade, patients having NLR >10 had significantly worse POP survival rate than patients having NLR ≤10. NLR at admission might be helpful as a predictor of POP in aSAH patients.