Cargando…

The Monocyte-to-Lymphocyte Ratio at Hospital Admission Is a Novel Predictor for Acute Traumatic Intraparenchymal Hemorrhage Expansion after Cerebral Contusion

PURPOSE: To explore the potential of monocyte-to-lymphocyte ratio (MLR) at hospital admission for predicting acute traumatic intraparenchymal hematoma (tICH) expansion in patients with cerebral contusion. Patients and Methods. This multicenter, observational study included patients with available at...

Descripción completa

Detalles Bibliográficos
Autores principales: Sheng, Jiangtao, Li, Tian, Zhuang, Dongzhou, Cai, Shirong, Yang, Jinhua, Ding, Faxiu, Chen, Xiaoxuan, Tian, Fei, Huang, Mindong, Li, Lianjie, Li, Kangsheng, Chen, Weiqiang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7785383/
https://www.ncbi.nlm.nih.gov/pubmed/33456370
http://dx.doi.org/10.1155/2020/5483981
_version_ 1783632431921758208
author Sheng, Jiangtao
Li, Tian
Zhuang, Dongzhou
Cai, Shirong
Yang, Jinhua
Ding, Faxiu
Chen, Xiaoxuan
Tian, Fei
Huang, Mindong
Li, Lianjie
Li, Kangsheng
Chen, Weiqiang
author_facet Sheng, Jiangtao
Li, Tian
Zhuang, Dongzhou
Cai, Shirong
Yang, Jinhua
Ding, Faxiu
Chen, Xiaoxuan
Tian, Fei
Huang, Mindong
Li, Lianjie
Li, Kangsheng
Chen, Weiqiang
author_sort Sheng, Jiangtao
collection PubMed
description PURPOSE: To explore the potential of monocyte-to-lymphocyte ratio (MLR) at hospital admission for predicting acute traumatic intraparenchymal hematoma (tICH) expansion in patients with cerebral contusion. Patients and Methods. This multicenter, observational study included patients with available at-hospital admission (baseline) and follow-up computed tomography for volumetric analysis (retrospective development cohort: 1146 patients; prospective validation cohort: 207 patients). Semiautomated software assessed tICH expansion (defined as ≥33% or 5 mL absolute growth). MLR was acquired from routine blood tests upon admission. We constructed two predictive models: basic combined model of clinical and imaging variables and MLR combined model of both MLR and other variables in the basic model. Receiver operating characteristic (ROC) analysis and decision curve analysis (DCA) were used to estimate the performance of MLR for predicting acute tICH expansion. RESULTS: MLR was significantly larger in patients with acute tICH expansion compared to those without acute tICH expansion (mean [SD], 1.08 [1.05] vs. 0.59 [0.37], P < 0.001). A nonlinear positive relationship between MLR and the incidence of acute tICH expansion was observed. Multivariate logistic regression indicated MLR as an independent risk factor for acute tICH expansion (odds ratio (OR), 5.88; 95% confidence interval (CI), 4.02-8.61). The power of the multivariate model for predicting acute tICH expansion was substantially improved with the inclusion of MLR (AUC 0.86 vs. AUC 0.74, P < 0.001), as was also observed in an external validation cohort (AUC 0.83 vs. AUC 0.71, P < 0.001). The net benefit of MLR model was higher between threshold probabilities of 20-100% in DCA. For clinical application, a nomogram derived from the multivariate model with MLR was introduced. In addition, MLR was positively associated with 6-month unfavorable outcome. CONCLUSION: MLR is a novel predictor for traumatic parenchymatous hematoma expansion. A nomogram derived from the MLR model may provide an easy-to-use tool for predicting acute tICH expansion and promoting the individualized treatment of patients with hemorrhagic cerebral contusion. MLR is associated with long-term outcome after cerebral contusion.
format Online
Article
Text
id pubmed-7785383
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Hindawi
record_format MEDLINE/PubMed
spelling pubmed-77853832021-01-14 The Monocyte-to-Lymphocyte Ratio at Hospital Admission Is a Novel Predictor for Acute Traumatic Intraparenchymal Hemorrhage Expansion after Cerebral Contusion Sheng, Jiangtao Li, Tian Zhuang, Dongzhou Cai, Shirong Yang, Jinhua Ding, Faxiu Chen, Xiaoxuan Tian, Fei Huang, Mindong Li, Lianjie Li, Kangsheng Chen, Weiqiang Mediators Inflamm Research Article PURPOSE: To explore the potential of monocyte-to-lymphocyte ratio (MLR) at hospital admission for predicting acute traumatic intraparenchymal hematoma (tICH) expansion in patients with cerebral contusion. Patients and Methods. This multicenter, observational study included patients with available at-hospital admission (baseline) and follow-up computed tomography for volumetric analysis (retrospective development cohort: 1146 patients; prospective validation cohort: 207 patients). Semiautomated software assessed tICH expansion (defined as ≥33% or 5 mL absolute growth). MLR was acquired from routine blood tests upon admission. We constructed two predictive models: basic combined model of clinical and imaging variables and MLR combined model of both MLR and other variables in the basic model. Receiver operating characteristic (ROC) analysis and decision curve analysis (DCA) were used to estimate the performance of MLR for predicting acute tICH expansion. RESULTS: MLR was significantly larger in patients with acute tICH expansion compared to those without acute tICH expansion (mean [SD], 1.08 [1.05] vs. 0.59 [0.37], P < 0.001). A nonlinear positive relationship between MLR and the incidence of acute tICH expansion was observed. Multivariate logistic regression indicated MLR as an independent risk factor for acute tICH expansion (odds ratio (OR), 5.88; 95% confidence interval (CI), 4.02-8.61). The power of the multivariate model for predicting acute tICH expansion was substantially improved with the inclusion of MLR (AUC 0.86 vs. AUC 0.74, P < 0.001), as was also observed in an external validation cohort (AUC 0.83 vs. AUC 0.71, P < 0.001). The net benefit of MLR model was higher between threshold probabilities of 20-100% in DCA. For clinical application, a nomogram derived from the multivariate model with MLR was introduced. In addition, MLR was positively associated with 6-month unfavorable outcome. CONCLUSION: MLR is a novel predictor for traumatic parenchymatous hematoma expansion. A nomogram derived from the MLR model may provide an easy-to-use tool for predicting acute tICH expansion and promoting the individualized treatment of patients with hemorrhagic cerebral contusion. MLR is associated with long-term outcome after cerebral contusion. Hindawi 2020-12-28 /pmc/articles/PMC7785383/ /pubmed/33456370 http://dx.doi.org/10.1155/2020/5483981 Text en Copyright © 2020 Jiangtao Sheng et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Sheng, Jiangtao
Li, Tian
Zhuang, Dongzhou
Cai, Shirong
Yang, Jinhua
Ding, Faxiu
Chen, Xiaoxuan
Tian, Fei
Huang, Mindong
Li, Lianjie
Li, Kangsheng
Chen, Weiqiang
The Monocyte-to-Lymphocyte Ratio at Hospital Admission Is a Novel Predictor for Acute Traumatic Intraparenchymal Hemorrhage Expansion after Cerebral Contusion
title The Monocyte-to-Lymphocyte Ratio at Hospital Admission Is a Novel Predictor for Acute Traumatic Intraparenchymal Hemorrhage Expansion after Cerebral Contusion
title_full The Monocyte-to-Lymphocyte Ratio at Hospital Admission Is a Novel Predictor for Acute Traumatic Intraparenchymal Hemorrhage Expansion after Cerebral Contusion
title_fullStr The Monocyte-to-Lymphocyte Ratio at Hospital Admission Is a Novel Predictor for Acute Traumatic Intraparenchymal Hemorrhage Expansion after Cerebral Contusion
title_full_unstemmed The Monocyte-to-Lymphocyte Ratio at Hospital Admission Is a Novel Predictor for Acute Traumatic Intraparenchymal Hemorrhage Expansion after Cerebral Contusion
title_short The Monocyte-to-Lymphocyte Ratio at Hospital Admission Is a Novel Predictor for Acute Traumatic Intraparenchymal Hemorrhage Expansion after Cerebral Contusion
title_sort monocyte-to-lymphocyte ratio at hospital admission is a novel predictor for acute traumatic intraparenchymal hemorrhage expansion after cerebral contusion
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7785383/
https://www.ncbi.nlm.nih.gov/pubmed/33456370
http://dx.doi.org/10.1155/2020/5483981
work_keys_str_mv AT shengjiangtao themonocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion
AT litian themonocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion
AT zhuangdongzhou themonocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion
AT caishirong themonocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion
AT yangjinhua themonocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion
AT dingfaxiu themonocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion
AT chenxiaoxuan themonocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion
AT tianfei themonocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion
AT huangmindong themonocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion
AT lilianjie themonocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion
AT likangsheng themonocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion
AT chenweiqiang themonocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion
AT shengjiangtao monocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion
AT litian monocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion
AT zhuangdongzhou monocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion
AT caishirong monocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion
AT yangjinhua monocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion
AT dingfaxiu monocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion
AT chenxiaoxuan monocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion
AT tianfei monocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion
AT huangmindong monocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion
AT lilianjie monocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion
AT likangsheng monocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion
AT chenweiqiang monocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion