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Open Access 01-12-2022 | Stroke | Research

Correlation between red blood cell distribution width, neutrophil to lymphocyte ratio, and neutrophil to platelet ratio with 3-month prognosis of patients with intracerebral hemorrhage: a retrospective study

Authors: Sheida Shaafi, Ehsan Bonakdari, Yalda Sadeghpour, Seyed Aria Nejadghaderi

Published in: BMC Neurology | Issue 1/2022

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Abstract

Background

Red cell distribution width (RDW) is a parameter that indsicates the heterogeneity of red blood cell size and could be a prognostic factor in some diseases. Also, intracerebral hemorrhage (ICH) is considered a vascular event with a high mortality rate. We aimed to examine the role of RDW, neutrophil to lymphocyte ratio (NLR), and neutrophil to platelet ratio (NPR) in predicting the prognosis of patients with ICH.

Methods

This is a retrospective cohort study conducted on 140 patients with ICH admitted to the neurology ward and intensive care unit (ICU) in Imam Reza Hospital, Tabriz, Iran. Demographic data, National Institutes of Health Stroke Scale (NIHSS), and complete blood count test parameters were evaluated within 24 h after hospitalization. These variables were collected and re-evaluated three months later.

Results

The mean age of the study population was 61.14 (± 16) years and 51% were male. The mean NLR (p = 0.05), neutrophil count (p=0.04), platelet count (p = 0.05), and NIHSS (p<0.01)  had a significant difference between the deceased patients and those who partially recovered after three months. The ROC curve showed that NIHSS (area under curve (AUC): 0.902), followed by NPR (AUC: 0.682) variables had the highest AUC.

Conclusion

RDW could be a relevant prognostic factor and predictor in determining 3-months survival in ICH. Nevertheless, further large-scale prospective cohorts might be needed to evaluate the associations.
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Literature
1.
go back to reference Lippi G, Plebani M. Red blood cell distribution width (RDW) and human pathology. One size fits all. Clin Chem Lab Med (CCLM). 2014;52(9):1247–9.PubMed Lippi G, Plebani M. Red blood cell distribution width (RDW) and human pathology. One size fits all. Clin Chem Lab Med (CCLM). 2014;52(9):1247–9.PubMed
2.
go back to reference Şenol K, Saylam B, Kocaay F, Tez M. Red cell distribution width as a predictor of mortality in acute pancreatitis. Am J Emerg Med. 2013;31(4):687–9.CrossRef Şenol K, Saylam B, Kocaay F, Tez M. Red cell distribution width as a predictor of mortality in acute pancreatitis. Am J Emerg Med. 2013;31(4):687–9.CrossRef
3.
go back to reference Sadaka F, O’Brien J, Prakash S. Red cell distribution width and outcome in patients with septic shock. J Intensive Care Med. 2012;28(5):307–13.CrossRef Sadaka F, O’Brien J, Prakash S. Red cell distribution width and outcome in patients with septic shock. J Intensive Care Med. 2012;28(5):307–13.CrossRef
4.
go back to reference Feng G-H, Li H-P, Li Q-L, Fu Y, Huang R-B. Red blood cell distribution width and ischaemic stroke. Stroke Vasc Neurol. 2017;2(3):172–5.CrossRef Feng G-H, Li H-P, Li Q-L, Fu Y, Huang R-B. Red blood cell distribution width and ischaemic stroke. Stroke Vasc Neurol. 2017;2(3):172–5.CrossRef
5.
go back to reference Förhécz Z, Gombos T, Borgulya G, Pozsonyi Z, Prohászka Z, Jánoskuti L. Red cell distribution width in heart failure: Prediction of clinical events and relationship with markers of ineffective erythropoiesis, inflammation, renal function, and nutritional state. Am Heart J. 2009;158(4):659–66.CrossRef Förhécz Z, Gombos T, Borgulya G, Pozsonyi Z, Prohászka Z, Jánoskuti L. Red cell distribution width in heart failure: Prediction of clinical events and relationship with markers of ineffective erythropoiesis, inflammation, renal function, and nutritional state. Am Heart J. 2009;158(4):659–66.CrossRef
6.
go back to reference Sousa R, Gonçalves C, Guerra IC, Costa E, Fernandes A, do BomSucesso M, et al. Increased red cell distribution width in Fanconi anemia: a novel marker of stress erythropoiesis. Orphanet J Rare Dis. 2016;11(1):102.CrossRef Sousa R, Gonçalves C, Guerra IC, Costa E, Fernandes A, do BomSucesso M, et al. Increased red cell distribution width in Fanconi anemia: a novel marker of stress erythropoiesis. Orphanet J Rare Dis. 2016;11(1):102.CrossRef
7.
go back to reference Adamsson Eryd S, Borné Y, Melander O, Persson M, Smith JG, Hedblad B, et al. Red blood cell distribution width is associated with incidence of atrial fibrillation. J Intern Med. 2014;275(1):84–92.CrossRef Adamsson Eryd S, Borné Y, Melander O, Persson M, Smith JG, Hedblad B, et al. Red blood cell distribution width is associated with incidence of atrial fibrillation. J Intern Med. 2014;275(1):84–92.CrossRef
8.
go back to reference Danese E, Lippi G, Montagnana M. Red blood cell distribution width and cardiovascular diseases. J Thorac Dis. 2015;7(10):E402–11.PubMedPubMedCentral Danese E, Lippi G, Montagnana M. Red blood cell distribution width and cardiovascular diseases. J Thorac Dis. 2015;7(10):E402–11.PubMedPubMedCentral
9.
go back to reference Gul M, Uyarel H, Ergelen M, Karacimen D, Ugur M, Turer A, et al. The relationship between red blood cell distribution width and the clinical outcomes in non-ST elevation myocardial infarction and unstable angina pectoris: A 3-year follow-up. Coron Artery Dis. 2012;23:330–6.CrossRef Gul M, Uyarel H, Ergelen M, Karacimen D, Ugur M, Turer A, et al. The relationship between red blood cell distribution width and the clinical outcomes in non-ST elevation myocardial infarction and unstable angina pectoris: A 3-year follow-up. Coron Artery Dis. 2012;23:330–6.CrossRef
10.
go back to reference Kaya A, Isik T, Kaya Y, Enginyurt O, Gunaydin ZY, Iscanli MD, et al. Relationship between red cell distribution width and stroke in patients with stable chronic heart failure: a propensity score matching analysis. Clin Appl Thromb Hemost. 2013;21(2):160–5.CrossRef Kaya A, Isik T, Kaya Y, Enginyurt O, Gunaydin ZY, Iscanli MD, et al. Relationship between red cell distribution width and stroke in patients with stable chronic heart failure: a propensity score matching analysis. Clin Appl Thromb Hemost. 2013;21(2):160–5.CrossRef
11.
go back to reference Tamhane UU, Aneja S, Montgomery D, Rogers E-K, Eagle KA, Gurm HS. Association Between Admission Neutrophil to Lymphocyte Ratio and Outcomes in Patients With Acute Coronary Syndrome. Am J Cardiol. 2008;102(6):653–7.CrossRef Tamhane UU, Aneja S, Montgomery D, Rogers E-K, Eagle KA, Gurm HS. Association Between Admission Neutrophil to Lymphocyte Ratio and Outcomes in Patients With Acute Coronary Syndrome. Am J Cardiol. 2008;102(6):653–7.CrossRef
12.
go back to reference Cai L, Zeng H, Tan X, Wu X, Qian C, Chen G. The Role of the Blood Neutrophil-to-Lymphocyte Ratio in Aneurysmal Subarachnoid Hemorrhage. Front Neurol. 2021;12:671098.CrossRef Cai L, Zeng H, Tan X, Wu X, Qian C, Chen G. The Role of the Blood Neutrophil-to-Lymphocyte Ratio in Aneurysmal Subarachnoid Hemorrhage. Front Neurol. 2021;12:671098.CrossRef
13.
go back to reference Xiao L, Zheng H, Li J, Wang Q, Sun H. Neuroinflammation Mediated by NLRP3 Inflammasome After Intracerebral Hemorrhage and Potential Therapeutic Targets. Mol Neurobiol. 2020;57(12):5130–49.CrossRef Xiao L, Zheng H, Li J, Wang Q, Sun H. Neuroinflammation Mediated by NLRP3 Inflammasome After Intracerebral Hemorrhage and Potential Therapeutic Targets. Mol Neurobiol. 2020;57(12):5130–49.CrossRef
14.
go back to reference Feigin VL, Stark BA, Johnson CO, Roth GA, Bisignano C, Abady GG, et al. Global, regional, and national burden of stroke and its risk factors, 1990–2019: A systematic analysis for the Global Burden of Disease Study 2019. The Lancet Neurology. 2021;20(10):795-820. https://doi.org/10.1016/S1474-4422(21)00252-0. Feigin VL, Stark BA, Johnson CO, Roth GA, Bisignano C, Abady GG, et al. Global, regional, and national burden of stroke and its risk factors, 1990–2019: A systematic analysis for the Global Burden of Disease Study 2019. The Lancet Neurology. 2021;20(10):795-820. https://​doi.​org/​10.​1016/​S1474-4422(21)00252-0.
15.
go back to reference Park C, Charalambous LT, Yang Z, Adil SM, Hodges SE, Lee H-J, et al. Inpatient mortality and healthcare resource utilization of nontraumatic intracerebral hemorrhage complications in the US. J Neurosurg JNS. 2021:1–10. Park C, Charalambous LT, Yang Z, Adil SM, Hodges SE, Lee H-J, et al. Inpatient mortality and healthcare resource utilization of nontraumatic intracerebral hemorrhage complications in the US. J Neurosurg JNS. 2021:1–10.
17.
go back to reference Ani C, Ovbiagele B. Elevated red blood cell distribution width predicts mortality in persons with known stroke. J Neurol Sci. 2009;277(1–2):103–8.CrossRef Ani C, Ovbiagele B. Elevated red blood cell distribution width predicts mortality in persons with known stroke. J Neurol Sci. 2009;277(1–2):103–8.CrossRef
18.
go back to reference Lorente L, Martín MM, González-Rivero AF, Pérez-Cejas A, Sabatel R, Ramos L, et al. Red blood cell distribution width and mortality of spontaneous intracerebral hemorrhage patients. Clin Neurol Neurosurg. 2020;195:106066.CrossRef Lorente L, Martín MM, González-Rivero AF, Pérez-Cejas A, Sabatel R, Ramos L, et al. Red blood cell distribution width and mortality of spontaneous intracerebral hemorrhage patients. Clin Neurol Neurosurg. 2020;195:106066.CrossRef
19.
go back to reference Ramírez-Moreno JM, Gonzalez-Gomez M, Ollero-Ortiz A, Roa-Montero AM, Gómez-Baquero MJ, Constantino-Silva AB. Relation between red blood cell distribution width and ischemic stroke: a case-control study. Int J Stroke. 2013;8(6):E36-E.CrossRef Ramírez-Moreno JM, Gonzalez-Gomez M, Ollero-Ortiz A, Roa-Montero AM, Gómez-Baquero MJ, Constantino-Silva AB. Relation between red blood cell distribution width and ischemic stroke: a case-control study. Int J Stroke. 2013;8(6):E36-E.CrossRef
20.
go back to reference Kara H, Degirmenci S, Bayir A, Ak A, Akinci M, Dogru A, et al. Red cell distribution width and neurological scoring systems in acute stroke patients. Neuropsychiatr Dis Treat. 2015;11:733–9.CrossRef Kara H, Degirmenci S, Bayir A, Ak A, Akinci M, Dogru A, et al. Red cell distribution width and neurological scoring systems in acute stroke patients. Neuropsychiatr Dis Treat. 2015;11:733–9.CrossRef
21.
go back to reference Silva Litao MK, Kamat D. Back to basics: red blood cell distribution width: clinical use beyond hematology. Pediatr Rev. 2018;39(4):204.CrossRef Silva Litao MK, Kamat D. Back to basics: red blood cell distribution width: clinical use beyond hematology. Pediatr Rev. 2018;39(4):204.CrossRef
22.
go back to reference Gattringer T, Posekany A, Niederkorn K, Knoflach M, Poltrum B, Mutzenbach S, et al. Predicting early mortality of acute ischemic stroke. Stroke. 2019;50(2):349–56.CrossRef Gattringer T, Posekany A, Niederkorn K, Knoflach M, Poltrum B, Mutzenbach S, et al. Predicting early mortality of acute ischemic stroke. Stroke. 2019;50(2):349–56.CrossRef
23.
go back to reference Yang W, Liu Y. Platelet-lymphocyte ratio is a predictor of venous thromboembolism in cancer patients. Thromb Res. 2015;136(2):212–5.CrossRef Yang W, Liu Y. Platelet-lymphocyte ratio is a predictor of venous thromboembolism in cancer patients. Thromb Res. 2015;136(2):212–5.CrossRef
24.
go back to reference Ozcan Cetin EH, Cetin MS, Aras D, Topaloglu S, Temizhan A, Kisacik HL, et al. Platelet to lymphocyte ratio as a prognostic marker of in-hospital and long-term major adverse cardiovascular events in st-segment elevation myocardial infarction. Angiology. 2015;67(4):336–45.CrossRef Ozcan Cetin EH, Cetin MS, Aras D, Topaloglu S, Temizhan A, Kisacik HL, et al. Platelet to lymphocyte ratio as a prognostic marker of in-hospital and long-term major adverse cardiovascular events in st-segment elevation myocardial infarction. Angiology. 2015;67(4):336–45.CrossRef
25.
go back to reference Kundi H, Balun A, Cicekcioglu H, Cetin M, Kiziltunc E, Cetin ZG, et al. The relation between platelet-to-lymphocyte ratio and pulmonary embolism severity index in acute pulmonary embolism. Heart Lung. 2015;44(4):340–3.CrossRef Kundi H, Balun A, Cicekcioglu H, Cetin M, Kiziltunc E, Cetin ZG, et al. The relation between platelet-to-lymphocyte ratio and pulmonary embolism severity index in acute pulmonary embolism. Heart Lung. 2015;44(4):340–3.CrossRef
26.
go back to reference Jickling GC, Liu D, Ander BP, Stamova B, Zhan X, Sharp FR. Targeting neutrophils in ischemic stroke: translational insights from experimental studies. J Cereb Blood Flow Metab. 2015;35(6):888–901.CrossRef Jickling GC, Liu D, Ander BP, Stamova B, Zhan X, Sharp FR. Targeting neutrophils in ischemic stroke: translational insights from experimental studies. J Cereb Blood Flow Metab. 2015;35(6):888–901.CrossRef
27.
go back to reference Maestrini I, Strbian D, Gautier S, Haapaniemi E, Moulin S, Sairanen T, et al. Abstract W P51: A Higher Neutrophil Count Before Thrombolysis Is Associated With Worse Outcome. Stroke. 2015;46(1suppl_1):AWP51-AWP. Maestrini I, Strbian D, Gautier S, Haapaniemi E, Moulin S, Sairanen T, et al. Abstract W P51: A Higher Neutrophil Count Before Thrombolysis Is Associated With Worse Outcome. Stroke. 2015;46(1suppl_1):AWP51-AWP.
28.
go back to reference He W, Ruan Y, Yuan C, Cheng Q, Cheng H, Zeng Y, et al. High Neutrophil-to-Platelet Ratio Is Associated With Hemorrhagic Transformation in Patients With Acute Ischemic Stroke. Front Neurol. 2019;10(1310). He W, Ruan Y, Yuan C, Cheng Q, Cheng H, Zeng Y, et al. High Neutrophil-to-Platelet Ratio Is Associated With Hemorrhagic Transformation in Patients With Acute Ischemic Stroke. Front Neurol. 2019;10(1310).
Metadata
Title
Correlation between red blood cell distribution width, neutrophil to lymphocyte ratio, and neutrophil to platelet ratio with 3-month prognosis of patients with intracerebral hemorrhage: a retrospective study
Authors
Sheida Shaafi
Ehsan Bonakdari
Yalda Sadeghpour
Seyed Aria Nejadghaderi
Publication date
01-12-2022
Publisher
BioMed Central
Keyword
Stroke
Published in
BMC Neurology / Issue 1/2022
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-022-02721-2

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