Analysis Of Risk Factors And Predictive Value Of Platelet Parameters,Neutrophil Count For Short-term Outcome With Spontaneous Intracerebral Hemorrhage

Objective:1.To study the relationship of platelet parameters,neutrophil count(NC)and the severity of spontaneous intracerebral hemorrhage(sICH);2.To investigate the factors of the short-term poor outcome with sICH;3.To assess the effects of platelet parameters and NC in predicting the outcome of sICH.Method:Demographics and clinical data of 124 patients who diagnosed sICH in the first affiliated hospital of Nanchang university during the period of May 2019 and December 2019 were analyzed retrospectively.According to the modified Rankin Scale(mRS)of the patients with sICH at 30 days,the patients were divided into favorable outcome(mRS score 0-2 points)and unfavorable outcome(mRS score 3-6points).To study correlations between platelet parameters,NC and National Institutes of Health Stroke Scale(NIHSS)score,Intracerebral hemorrhage(ICH)Score,Glasgow coma scale(GCS)score,Spearman correlation coefficients were used.We used multivariate logistic regression analysis to identify the independent factors with the poor outcome of sICH.The Area Under ROC Curve(AUC)of platelet parameters,NC and combined platelet parameters with NC can be obtained by establishing their Receiver operator characteristic curve(ROC),which can determine their prognostic value to the short-term outcome of sICH.Results:The correlations between Platelet count(PLT)and NIHSS score was positive(r_s=-0.200,P<0.05).The NC was moderately correlated to the NIHSS score(r_s=0.269,P<0.05),ICH(rs=0.328,P<0.01)and GCS socre(r_s=-0.198,P<0.05).This study found that patients of sICH with higher NC,advanced age and lager initial hematoma volume showed higher risk of a poor outcome at 30 days.Patients with sICH,who had higher PLT and non-intraventricular hemorrhage,showed a positive factor to improve the outcome of patients with sICH at 30 days.The AUC of PLT and NC were 0.660(95%CI 0.562-0.758,P=0.002)and 0.655(95%CI 0.557-0.754,P=0.003),which could predict the prognosis of patients with sICH at 30 days.The AUC of PLT combined with NC was 0.78(95%CI0.698-0.863,P<0.001),and the accuracy would significantly increased when PLT combined with NC.The best predictive cut-off value of PLT and NC were177.00×10~9(sensitivity 62.3%,specificity 66.2%)and 8.54×10~9(sensitivity 43.4%,specificity 85.9%).Conclusion:1.Patients diagnosed sICH with higher NC have higher NIHSS score and ICH score,lower GCS score,and tend to be a poor short-term prognosis.2.Higher NC,advanced age and lager initial hematoma volume were independent risk factors for short-term poor outcome of patients with sICH.3.Increased PLT and non-intraventricular hemorrhage are protective factors for short-term prognosis of patients with sICH.4.PLT and NC could predict the prognosis of patients with sICH,the accuracy of predicting the prognosis would significantly increased by PLT combined with NC.