Correlation Between Early Brain Injury After Aneurysmal Subarachnoid Hemorrhage And Peripheral Inflammation

Objective: Previous studies have shown that early brain injury(EBI)after aneurysmal subarachnoid hemorrhage(a SAH)is associated with peripheral inflammation.In recent years,neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)have received extensive attention as new peripheral inflammation markers.Therefore,the purpose of this study was to investigate the correlation between peripheral NLR,PLR and EBI after a SAH and the prognosis.Methods: The 97 resident patients with a SAH were retrospectively analyzed in the Department of Neurosurgery,the First Affiliated Hospital of Guangxi Medical University.The current imaging indicator used to evaluate EBI is subarachnoid hemorrhage early brain edema score(SEBES).The clinical indicator used to assess EBI is hunt-hess grade(HH).The prognostic indicator for patients after a SAH is modified rankin score(MRS).To explore the correlation between NLR,PLR and EBI and their prognosis at admission after a SAH,the 97 resident patients were separated into two groups based on the level of SEBES,HH and the MRS: the high SEBES group(SEBES≥3,n=56),the low SEBES group(SEBES≤2,n=41),the high HH group(HH≥4,n=38),the low HH group(HH≤3,n=59),the high MRS group(MRS≥3,n=39)and the low MRS group(MRS≤2,n=58).Results: In the 97 resident patients in this research,56(58%)patients’ SEBES≥3,41(42%)patients’ SEBES≤2,38(39%)patients’ HH≥4,59(61%)patients’ HH≤3,58(60%)patients’ MRS≤2 and 39(40%)patients’ MRS≥3.NLR and PLR are elevated in the high SEBES group,high HH group and high MRS group compared with the low SEBES group,low HH group and low MRS group.Higher HH grading at admission was independently associated with adverse outcomes in a SAH patients(OR=10.054,95%CI 1.352-74.773,P=0.024<0.05).Higher SEBES at admission was independently associated with adverse outcomes in a SAH patients(OR=21.086,95%CI 1.675～265.492,P=0.018<0.05).Higher NLR at admission was independently associated with adverse outcomes in a SAH patients(OR=2.352,95%CI 1.036～5.336,P=0.041<0.05).Conclusion: The increase of NLR and PLR at admission was correlated with the severity of EBI after a SAH.Peripheral inflammatory activity increased in EBI after a SAH,suggesting that PLR and NLR are potential biomarkers for predicting the severity of EBI.Higher NLR,HH and SEBES were risk factors for adverse outcomes after a SAH.