Influence of Peripheral Blood Inflammatory Indices on the Distance of Growth and Prognosis of Peripheral Edema in Basal Ganglia Cerebral Hemorrhages

Background

To investigate the effects of peripheral blood inflammatory markers, such as the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), perihematomal edema (PHE), edema extension distance (EED), EED growth, and functional prognosis in patients with basal ganglia hemorrhage.

Methods

The clinical data of patients with basal ganglia cerebral hemorrhage observed in the Department of Neurosurgery at Dangtu County People's Hospital between January 2017 and June 2023 were retrospectively collected. The primary outcomes were absolute PHE, relative PHE, EED, and EED growth. The secondary outcome was the clinical status 90 days postdischarge, assessed using the modified Rankin scale (mRS). Scores of 3–6 on the mRS indicate unfavorable functional outcomes.

Results

A total of 83 patients with basal ganglia cerebral hemorrhage were enrolled, with a median age of 67.0 years (interquartile range, 58.0–73.0) and 75.9% male predominance. Poor functional outcomes (mRS 3–6) were observed in 48 patients (57.8%) at the 90-day follow-up. Univariate linear regression analysis revealed no significant association between inflammatory ratios (NLR, LMR, and PLR) and PHE dynamics at both baseline and 24–72 hours measurements. Adjusted multivariate logistic regression analysis identified the baseline NLR and PLR as independent predictors of intracerebral hemorrhage in the basal ganglia. Receiver operating characteristic curve analysis revealed that baseline NLR had superior discriminative capacity (area under the curve [AUC] = 0.854; 95% confidence interval [CI], 0.767–0.927) compared to PLR (AUC = 0.787; 95% CI, 0.689–0.874) and hematoma volume (AUC = 0.788; 95% CI, 0.676–0.881). The optimal prognostic thresholds were NLR = 5.90, PLR = 141.53, and hematoma volume = 10.40 ml.

Conclusions

Although NLR, LMR, and PLR were not independent predictors of PHE progression in basal ganglia cerebral hemorrhage, they can be used as simple, noninvasive tools to predict the prognosis of patients with basal ganglia hematomas. Risk stratification can be enhanced by identifying patients requiring intensified monitoring or early neuroprotective interventions.