Assessing Diagnostic Utility of NLR to Predict Poor Functional Outcomes in Patients with Hemorrhagic Stroke and To Compare it with the Intracranial Hemorrhage (ICH) Score: A Comparative Study
Authors/Creators
- 1. Senior Resident, Department of Anesthesiology and Critical Care, AIIMS, Patna, Bihar, India
- 2. Senior Resident, Department of General Medicine (Emergency) IGIMS, Patna, Bihar India
Description
Abstract
Aim: The aim of this study was to evaluate the diagnostic utility of NLR to predict poor functional outcomes in
patients with hemorrhagic stroke and to compare it with the intracranial hemorrhage (ICH) score.
Material & Methods: Patients who presented to the emergency department with clinical features suggestive of
stroke were evaluated with computed tomography (CT) brain to identify ICH. The ICH scores and NLR were
estimated at the time of admission. Modified Rankin Scale (mRS) score equal to or greater than 3 at 90 days was
used to define poor functional outcomes (major disability or death). Receiver operating characteristic (ROC)
curve was plotted with NLR and the ICH score to analyze and compare their discriminative ability to predict
poor functional outcomes.
Results: A total of 100 patients were included in this study, 65 males and 35 females. The mean age of the study
group was 64.6 years (SD = 12.6). 32% had ICH score 2 followed by 21% had ICH score 1. Of the total 100
patients, 65 subjects (65%) had mRS score greater than or equal to 3 at 90 days. These patients were categorized
as the poor functional outcome group. 35 patients (35%) had mRS score less than 3 at 90 days and were
categorized as the good outcome group. The all-cause mortality at 90 days was 16 (16%) in the study. The
difference of Laboratory variables and the ICH score according to 90 days of outcomes were found to be
statistically significant. At their cutoff values, NLR compared to the ICH score was found to be more sensitive
but less specific. There was no significant difference in accuracy between NLR and the ICH score.
Conclusion: In patients with hemorrhagic stroke, NLR at admission is a good predictor of functional outcomes
at 90 days. When compared to the ICH score, NLR is more sensitive but less specific in predicting poor
functional outcomes.
Abstract (English)
Abstract
Aim: The aim of this study was to evaluate the diagnostic utility of NLR to predict poor functional outcomes in
patients with hemorrhagic stroke and to compare it with the intracranial hemorrhage (ICH) score.
Material & Methods: Patients who presented to the emergency department with clinical features suggestive of
stroke were evaluated with computed tomography (CT) brain to identify ICH. The ICH scores and NLR were
estimated at the time of admission. Modified Rankin Scale (mRS) score equal to or greater than 3 at 90 days was
used to define poor functional outcomes (major disability or death). Receiver operating characteristic (ROC)
curve was plotted with NLR and the ICH score to analyze and compare their discriminative ability to predict
poor functional outcomes.
Results: A total of 100 patients were included in this study, 65 males and 35 females. The mean age of the study
group was 64.6 years (SD = 12.6). 32% had ICH score 2 followed by 21% had ICH score 1. Of the total 100
patients, 65 subjects (65%) had mRS score greater than or equal to 3 at 90 days. These patients were categorized
as the poor functional outcome group. 35 patients (35%) had mRS score less than 3 at 90 days and were
categorized as the good outcome group. The all-cause mortality at 90 days was 16 (16%) in the study. The
difference of Laboratory variables and the ICH score according to 90 days of outcomes were found to be
statistically significant. At their cutoff values, NLR compared to the ICH score was found to be more sensitive
but less specific. There was no significant difference in accuracy between NLR and the ICH score.
Conclusion: In patients with hemorrhagic stroke, NLR at admission is a good predictor of functional outcomes
at 90 days. When compared to the ICH score, NLR is more sensitive but less specific in predicting poor
functional outcomes.
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IJCPR,Vol15,Issue10,Article104.pdf
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Additional details
Dates
- Accepted
-
2023-09-24