
Vijay Kumar
All India Institute of Medical Sciences, IndiaPresentation Title:
Neutrophil-to-lymphocyte ratio as a prognostic marker of functional outcome in patients with Intracerebral Haemorrhage (ICH) and its comparison with ICH Score: A hospital based study
Abstract
Stroke ranks among the top causes of disability and is the second most common cause of death globally. We have evaluated the utility of using neutrophil to lymphocyte ratio as a prognostic marker in patients with acute Intracerebral haemorrhage and we have further tried to validate its prognostic significance by comparing the outcome with ICH score which is a well validated and established system for 30 day outcome of patients with haemorrhagic stroke. We conducted a prospective observational study involving 120 patients presenting to the emergency department with Haemorrhagic Stroke, after obtaining informed consent. Baseline demographics and ICH score were recorded upon presentation. Complete blood count analysis provided values for Absolute Neutrophil Count (ANC) and Absolute Lymphocyte Count (ALC), from which Neutrophil to Lymphocyte Ratio (NLR) was calculated at admission. The study endpoint was functional outcome at 90 days post-discharge, assessed using the Modified Rankin Scale (mRS). Functional outcome was evaluated at discharge (Day 0) and at the 90-day follow-up via patient examination or telephonic conversation. Patients with mRS ≥ 3 were classified as having poor functional outcomes. On day 90, the median Neutrophil To Lymphocyte Ratio was 5.5 for the Good outcome group and 8.95 for the Poor outcome group. A significant difference was found between the two groups (W = 867.500, p < 0.001), with the Poor outcome group showing the highest median NLR.ROC analysis was done which showed that at a cutoff of Neutrophil to specificity of 72%. However on comparing NLR with ICH score, at a cutoff of ICH Score ≥ 2, it predicts mRS Category on day 90 as poor with a sensitivity of 68%, and a specificity of 85% which proves that ICH score has a better specificity in predicting the 90 day outcome. In summary, our study links Neutrophil to Lymphocyte Ratio (NLR) with post-Intracerebral Hemorrhage (ICH) outcomes. Higher NLR on day 90 correlates with poorer prognosis. NLR cutoff of ≥7.2 predicts poor outcome with 68% sensitivity and 72% specificity, while ICH score (≥2) shows comparable sensitivity (68%) but higher specificity (85%). This highlights the ICH score≥39;s superior specificity in predicting poor functional outcomes, emphasizing the need for multifactorial prognostic assessment in ICH patients.
Biography
Vijay Kumar has completed his M.D. in General medicine with a special interest in Neurology. He has more than 40 publications and more than ten chapters in various books. He is working as a senior faculty at the Institute of National Importance, All India Institute of Medical Sciences (AIIMS), Patna, India. He is also a member of the editorial board of several journals. He is also a reviewer of Various International and National Journals. He is working as Unit Head at AIIMS and supervising several Postgraduate students in his clinical and research works.