Correlation Study Of C-reactive Protein To Albumin Ration Combined With Clinically Relevant Data In Evaluating Prognostic Value Of Neurological Function In Patients With Hypertensive Cerebral Hemorrhage

Objective: By observing the changes of C-reactive protein/serum albumin(CAR)before surgery and on the third day after surgery,this study evaluated the effect of CAR on the prognosis of neurological function in patients with hypertensive cerebral hemorrhage.To explore the value of CAR combined with clinical data in evaluating the28-day prognosis of nerve function in hypertensive cerebral hemorrhage patients.Methods: This experiment included 111 hypertensive cerebral hemorrhage patients admitted to the neurosurgery department of Tianshui First People’s Hospital from June 2021 to July 2022,and all patients underwent surgical treatment within 24 hours of admission.After admission,CRP and ALB were collected before and on the3 rd day after surgery,and CAR was calculated before and on the 3rd day after surgery.The improved Rankin score(mRS Score)was used to evaluate the 28-day neurological function prognosis of the patients.According to the score,the patients were divided into two groups,mRS Score 0-3: good prognosis group,mRS Score 4-6: poor prognosis group.The data changes of CRP,ALB and CAR were compared between the two groups before surgery and the third day after surgery,and the influencing factors affecting the outcome of 28-day neurological function rehabilitation of patients were analyzed.Multivariate binary logistic regression analysis was performed on the significant factors affecting the prognosis of neurological function,and the odds ratio(OR)and 95% confidence interval(CI)were described,and the prediction model was established.Receiver operating characteristic(ROC)curves were plotted to evaluate the value of CAR combined with clinically relevant data on the outcome of 28-day neurological recovery in hypertensive cerebral hemorrhage patients.Result1.The 28-day neurological function recovery outcome of hypertensive cerebral hemorrhage patients in the two groups was observed,and it was found that the age of patients,the total amount of hematoma and GCS score affected the neurological function recovery outcome of hypertensive cerebral hemorrhage patients,with statistical significance(P < 0.05).There was no significant difference between the clinical data of bleeding location,operation method,hospital stay,intraoperative blood loss and postoperative complications and the outcome of 28-day neurological function recovery(P > 0.05).2.Spearman rank correlation test analysis showed that GCS score,ALB before and 3 days after surgery were negatively correlated with 28-day neurological function recovery in hypertensive cerebral hemorrhage patients(r:-0.270,-0.171,-0.326,P <0.001);Age(r: 0.518),hematoma volume(r: 0.424),preoperative CRP(r: 0.141),preoperative CAR(r: 0.385),postoperative CRP(r: 0.418)and postoperative CAR(r:0.475)were positively correlated with the outcome of 28-day neurological recovery in hypertensive cerebral hemorrhage patients.3.Logistic multivariate regression analysis was used: age,total hematoma,GCS score,and CAR on the 3rd day after surgery were independent risk factors for the outcome of 28-day neurological recovery in hypertensive cerebral hemorrhage patients.4.Experimental results of CRP,ALB and CAR: CRP and CAR in the poor prognosis group were higher than those in the good prognosis group before and 3 days after surgery,and ALB in the poor prognosis group was lower than that in the good prognosis group before and 3 days after surgery.5.The area under ROC curve(AUC)of the CAR on day 3 after surgery was 0.803,the optimal cut-off point was 0.43,the sensitivity was 73.8%,the specificity was 76.1%,and the Yoden index was 0.499.The area under the age ROC curve(AUC)was 0.797,the best cut-off point was 56.5,the sensitivity was 75.4%,the specificity was 73.9%,and the Yoden index was 0.493.The area under ROC curve(AUC)of hematoma was0.745,the best cut-off point was 53.5,the sensitivity was 55.4%,the specificity was93.5%,and the Yoden index was 0.489.The area under the ROC curve(AUC)of the GCS score was 0.152,the optimal cut-off point was 8.5,the sensitivity was 70.8%,the specificity was 84.8%,and the Yoden index was 0.556.The area under the ROC curve(AUC)of the prediction probability model was 0.876,the optimal cut-off point was0.59,the sensitivity was 76.9%,and the specificity was 82.6%.Jorden index 0.595.Conclusion1.CRP,CAR and ALB were compared with those before operation on the 3rd day after operation,CRP,CAR and ALB were gradually increased,while ALB was gradually decreased.In hypertensive intracerebral hemorrhage patients,the poor prognosis of neurological function was aggravated,CRP and CAR were gradually increased,and ALB was gradually decreased.2.GCS score,ALB before and 3 days after surgery were negatively correlated with the degree of 28-day neurological function recovery in hypertensive intracerebral hemorrhage patients;Age,hematoma volume,CRP and CAR were positively correlated with the outcome of 28-day neurological recovery in hypertensive intracerebral hemorrhage patients.3.Age,hematoma volume,GCS score,and CAR on day 3 after surgery were independent risk factors for the outcome of 28-day neurological recovery in hypertensive intracerebral hemorrhage patients.4.The area under ROC curve of CAR on the 3rd day after surgery was the largest,and it had a high value in predicting the 28-day prognosis of neurological function in hypertensive intracerebral hemorrhage patients.When the optimal cut-off point was0.43,the AUC was 0.803,the sensitivity was 73.8%,the specificity was 76.1%,and the Yoden index was 0.499.The prediction probability model,which consisted of age,hematoma volume,GCS score and CAR on the 3rd day after surgery,improved the prediction value of 28-day neurological rehabilitation outcome in hypertensive intracerebral hemorrhage patients.The optimal cut-off point was 0.59,the AUC was0.876,the sensitivity was 76.9%,the specificity was 82.6%,and the Yoden index was0.595(P<0.001).