AUTHOR=Guo Peixin , Zou Wei 

TITLE=Neutrophil-to-lymphocyte ratio, white blood cell, and C-reactive protein predicts poor outcome and increased mortality in intracerebral hemorrhage patients: a meta-analysis

JOURNAL=Frontiers in Neurology

VOLUME=14

YEAR=2024

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1288377

DOI=10.3389/fneur.2023.1288377

ISSN=1664-2295

ABSTRACT=<sec id="sec1"><title>Objective</title><p>Inflammation participates in the pathology and progression of secondary brain injury after intracerebral hemorrhage (ICH). This meta-analysis intended to explore the prognostic role of inflammatory indexes, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), white blood cell (WBC), and C-reactive protein (CRP) in ICH patients.</p></sec><sec id="sec2"><title>Methods</title><p>Embase, PubMed, Web of Science, and Cochrane Library were searched until June 2023. Two outcomes, including poor outcome and mortality were extracted and measured. Odds ratio (OR) and 95% confidence interval (CI) were presented for outcome assessment.</p></sec><sec id="sec3"><title>Results</title><p>Forty-six studies with 25,928 patients were included in this meta-analysis. The high level of NLR [OR (95% CI): 1.20 (1.13–1.27), <italic>p</italic> &lt; 0.001], WBC [OR (95% CI): 1.11 (1.02–1.21), <italic>p</italic> = 0.013], and CRP [OR (95% CI): 1.29 (1.08–1.54), <italic>p</italic> = 0.005] were related to poor outcome in ICH patients. Additionally, the high level of NLR [OR (95% CI): 1.06 (1.02–1.10), <italic>p</italic> = 0.001], WBC [OR (95% CI): 1.39 (1.16–1.66), <italic>p</italic> &lt; 0.001], and CRP [OR (95% CI): 1.02 (1.01–1.04), <italic>p</italic> = 0.009] were correlated with increased mortality in ICH patients. Nevertheless, PLR was not associated with poor outcome [OR (95% CI): 1.00 (0.99–1.01), <italic>p</italic> = 0.749] or mortality [OR (95% CI): 1.00 (0.99–1.01), <italic>p</italic> = 0.750] in ICH patients. The total score of risk of bias assessed by Newcastle-Ottawa Scale criteria ranged from 7–9, which indicated the low risk of bias in the included studies. Publication bias was low, and stability assessed by sensitivity analysis was good.</p></sec><sec id="sec4"><title>Conclusion</title><p>This meta-analysis summarizes that the high level of NLR, WBC, and CRP estimates poor outcome and higher mortality in ICH patients.</p></sec>