Can neutrophil/lymphocyte ratio and mean platelet volume values be used as early markers in assessing the prognosis of patients with aneurysmal subarachnoid hemorrhage?

Abstract

Inflammation plays an important role in cerebrovascular diseases, including intracerebral hemorrhage. Assessing the prognosis of such hemorrgage at early stage adds significance to treatment outcome. In this study, for the first time, we used neutrophil/lymphocyte (N/L) ratio and mean platelet volume (MPV) values as early markers in assessing the prognosis of patients with aneurysmal subarachnoid hemorrhage (SAH). This retrospective study included 50 patients with aneurysmal SAH who were diagnosed, hospitalized, treated, and follow-up with angiography between 2015 and 2016 (Gr. I). Blood count parameters and their clinical status after application (the first-arrival Glasgow coma score [GCS]) and at discharge (Glasgow outcome score [GOS]) were examined. The MPV value and N/L ratio were compared with that of the nonaneurysmatic control group (group 2, n = 50). The N/L ratio of Gr. I (median: 10.80) was significantly higher than that of the control group (median: 2.20) (P <0.05). The GCS (median: 10.0) and GOS (median: 3.0) of Gr. I were significantly lower than those of the control group (median GCS: 15.00, median GOS: 5.00) (P <0.05). MPV values were not different between the two groups (P >0.05). In the aneurysm group, the higher the N/L ratio, the lower the GCS and GOS, while the lower the N/L ratio, the higher the GCS and GOS. In patients with aneurysmal SAH, the inflammation level was associated with disease severity, which can be considered as an early treatment and prognostic marker. The initial application of the N/L ratio may be important in assessing the prognosis, and a lower N/L ratio may be used as a simple, effective, and important marker to estimate the better prognosis of patients with aneurysmal SAH.