LAUSR

OBJECTIVE This study aims to evaluate whether the postoperative neutrophil to lymphocyte ratio (NLR) is a prognostic marker for patients with intracerebral hemorrhage (ICH) undergoing surgical hematoma evacuation. METHODS A retrospective cohort study was conducted to identify patients with ICH who underwent hematoma evacuation from January 2013 to December 2018. Data on demographics, clinical features, laboratory tests (admission and postoperative) and imaging information were collected. The associations between variables and 30-day mortality were assessed by multivariable logistic regression analysis. The predictive power of independent predictors was evaluated by receiver operating characteristic curve (ROC). RESULTS A total of 380 patients were included. Multivariable analysis identified admission Glasgow Coma Scale score (odds ratio [OR] 0.61; 95% confidence interval [CI] 0.53-0.70, P < 0.001) and initial hematoma volume (OR 1.01; 95% CI 1.01-1.02, P = 0.022) were independently associated with 30-day mortality. With regard to laboratory biomarkers, postoperative NLR (OR 1.04; 95% CI 1.01-1.08, P = 0.014) was independently correlated with 30-day death, but admission NLR (OR 1.00; 95% CI 0.97-1.03, P = 0.944) was not. The best predictive cut-off point of 12.97 for postoperative NLR (area under curve 0.606, P = 0.006) for predicting 30-day mortality was determined by ROC analysis. CONCLUSIONS In patients with ICH undergoing hematoma evacuation, admission Glasgow Coma Scale score, initial hematoma volume and postoperative NLR were independently associated with 30-day mortality. Postoperative NLR may be a prognostic marker in surgical ICH patients and future studies are needed to confirm this finding.