Neutrophil-to-lymphocyte ratio predicts hematoma growth in intracerebral hemorrhage

OBJECTIVE: Early hematoma growth is a major determinant of early neurological deterioration and poor clinical outcome in patients with spontaneous intracerebral hemorrhage (ICH). Inflammation plays a major role in the pathophysiology of ICH. This study aimed to evaluate the potential of the neutrophil-to-lymphocyte ratio (NLR) for predicting early hematoma growth after ICH. METHODS: A retrospective review was performed of patients with acute spontaneous ICH who were admitted to the Stroke Center of the First People’s Hospital of Jingmen between January 2014 and January 2017. The NLR was computed from admission blood work. Brain computed tomography scans were performed at admission and repeated within 24 hours. Hematoma growth was defined as absolute growth >6 mL or relative growth >33%. RESULTS: A total of 123 patients were included and early hematoma growth occurred in 30 (24%) patients. Multivariate analysis showed that the NLR (odds ratio, 1.22; 95% confidence interval, 1.09–1.38) was independently associated with early hematoma growth. The best predictive cut-off of the NLR for early hematoma growth was 6.49 (sensitivity, 50%; specificity, 69%). CONCLUSIONS: A high NLR is independently predictive of early hematoma growth and may aid in risk stratification of patients with ICH on admission.