Diagnostic value of inflammatory indexes combined with myocardial enzymes for aneurysmal subarachnoid hemorrhage in patients with intracranial aneurysms

Objective

The purpose of the study is to evaluate the diagnostic ability of inflammatory indexes alone and in combination with myocardial enzymes in the prediction of aneurysmal subarachnoid hemorrhage (aSAH).

Materials and methods

This is a 1:1 age- and sex-matched case-control study in Tianjin, China. 226 patients aged > 18 years divided into aSAH group and unruptured intracranial aneurysm (UIA) group. Logistic regression models assessed associations between inflammatory indexes/myocardial enzymes and aSAH. Receiver operating characteristic (ROC) curves evaluated their sensitivity/specificity for aSAH.

Results

Higher neutrophil-to-lymphocyte ratio (NLR) (OR: 1.130, 95 % CI: 1.074, 1.188), monocyte-to-lymphocyte ratio (MLR) (OR: 11.144, 95 % CI: 3.071, 40.437), platelet-to-lymphocyte ratio (PLR) (OR: 1.006, 95 % CI: 1.003, 1.008), systemic immune-inflammatory index (SII) (OR: 1.000, 95 % CI: 1.000, 1.001) and systemic inflammation response index (SIRI) (OR: 1.228, 95 % CI: 1.112, 1.357), myocardial enzymes lactate dehydrogenase (LDH) (OR: 1.008, 95 % CI: 1.003, 1.014), creatine kinase (CK) (OR: 1.002, 95 % CI: 1.000, 1.004), and α-hydroxybutyrate dehydrogenase (HBDH) (OR: 1.010, 95 % CI: 1.002, 1.018) were all significantly associated with the presence of aSAH. The diagnostic value of inflammatory indexes (NLR-PLR-MLR-SII-SIRI) and myocardial enzymes (LDH-HBDH-CK-CKMB) gave an AUC of 0.771 and 0.662 (all P-value < 0.001), respectively. Combined use of these indexes achieved an AUC of 0.755 (P-value< 0.001), suggesting potential value as a diagnostic adjunct for aSAH.

Conclusions

The results suggest that higher inflammatory indexes and myocardial enzymes were associated with the presence of aSAH. The combination of inflammatory indexes and myocardial enzymes may serve as a diagnostic complement for identifying aSAH in patients with IA.