Early increase of neutrophil‐to‐lymphocyte ratio predicts 30‐day mortality in patients with spontaneous intracerebral hemorrhage

AIMS: To examine whether early rise of neutrophil‐to‐lymphocyte ratio (NLR) after patient hospitalization correlates with 30‐day mortality in patients with spontaneous intracerebral hemorrhage (ICH). METHODS: This retrospective study included all patients receiving treatment for spontaneous ICH between January 2015 and September 2016 at the Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences in Shanghai, China. NLR was determined at admission (T1), at 24‐48 hours (T2) and 5‐7 days (T3). NLR and clinicopathologic features were compared between those who survived for >30 days vs not. Multivariate regression was used to identify risk factors for 30‐day mortality. RESULTS: A total of 275 subjects were included in the analysis: 235 survived for at least 30 days; the remaining 40 subjects died within 30 days. The patients who died within 30 days had higher ICH score, larger ICH volume, and lower GCS score (all P < 0.05). In comparison with the baseline (NLR(T) (1)), NLR at 24‐48 hours (NLR(T) (2)) and 5‐7 days (NLR(T) (3)) was significantly higher in patients who died within 30 days (P < 0.05), but not in patients surviving for >30 days. In the multivariate analysis, the 30‐day mortality was associated with both NLR(T) (2) (OR 1.112, 95%CI 1.032‐1.199, P = 0.006) and NLR(T) (3) (OR 1.163, 95%CI 1.067‐1.268, P = 0.001). Spearman correlation analysis showed that both NLR(T) (2) and NLR(T) (3) correlated inversely with GCS score and positively with ICH score and ICH volume at the baseline. CONCLUSIONS: Early rise of NLR predicts 30‐day mortality in patients with spontaneous ICH.