ArticleActa neurologica Belgica2021
Systemic inflammation status at admission affects the outcome of intracerebral hemorrhage by increasing perihematomal edema but not the hematoma growth.
Article in Acta neurologica Belgica, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
31 citing papers in PubMed, 5 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Pooled it
- Pooled it
- Association between circulating inflammatory biomarkers and functional outcome or perihaematomal oedema after ICH: a systematic review & meta-analysis.Wellcome open research · 2023Pooled it
- Neutrophil-to-lymphocyte ratio, white blood cell, and C-reactive protein predicts poor outcome and increased mortality in intracerebral hemorrhage patients: a meta-analysis.Frontiers in neurology · 2023Pooled it
- Prognostic Role of the Neutrophil-to-Lymphocyte Ratio in Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis.Frontiers in neuroscience · 2022Pooled it
- Neutrophil Extracellular Traps in Patients with Intracerebral Hemorrhage.Neurocritical care · 2026Article
- Differential Risk Factors for Hematoma Expansion in Deep and Lobar Intracerebral Hemorrhage.Neurocritical care · 2025Article
- Association between neutrophil-to-lymphocyte ratio and hematoma expansion in spontaneous intracerebral hemorrhage: A systematic review and meta-analysis.World journal of critical care medicine · 2025Article
- Neutrophil-to-lymphocyte ratio and systemic inflammation response index as biomarkers for the clinical outcomes of intracerebral hemorrhagic stroke patients: a prospective cohort study.Frontiers in neurology · 2025Article
- Fibrinogen-to-Albumin Ratio as a Novel Predictor of Intracerebral Hemorrhage in Maintenance Hemodialysis Patients.Journal of inflammation research · 2025Article
- Exploring the associations of gut microbiota with inflammatory and the early hematoma expansion in intracerebral hemorrhage: from change to potential therapeutic objectives.Frontiers in cellular and infection microbiology · 2025Article
- A Prospective Cohort Study of Elevated Serum NLRP1 Levels to Prognosticate Neurological Outcome After Acute Intracerebral Hemorrhage at a Single Academic Institution.Neuropsychiatric disease and treatment · 2024Article
- Association between neutrophil-to-lymphocyte ratio and short-term all-cause mortality in patients with cerebrovascular disease admitted to the intensive care unit-a study based on the MIMIC-IV database.Frontiers in medicine · 2024Article
- More severe initial manifestations and worse short-term functional outcome of intracerebral hemorrhage in the plateau than in the plain.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2024Article
- Development and validation of a random forest model to predict functional outcome in patients with intracerebral hemorrhage.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2023Article
- Low-intensity pulsed ultrasound ameliorates glia-mediated inflammation and neuronal damage in experimental intracerebral hemorrhage conditions.Journal of translational medicine · 2023Article
- Serum Urea-to-Albumin Ratio Is an Independent Predictor of Intra-Hospital Mortality in Neurosurgical Intensive Care Unit Patients with Spontaneous Intracerebral Hemorrhage.Journal of clinical medicine · 2023Article
- The Clinical Value of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio for Predicting Hematoma Expansion and Poor Outcomes in Patients with Acute Intracerebral Hemorrhage.Journal of clinical medicine · 2023Article
- Association between high serum blood glucose lymphocyte ratio and all-cause mortality in non-traumatic cerebral hemorrhage: a retrospective analysis of the MIMIC-IV database.Frontiers in endocrinology · 2023Article
- Stroke and Emerging Blood Biomarkers: A Clinical Prospective.Neurology international · 2022Review
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Acute stress and inflammation responses are associated with worse outcomes in intracerebral hemorrhage (ICH) but the precise mechanisms involved are unclear. We evaluated the effect of neutrophil-to-lymphocyte ratio (NLR) in ICH outcome, with focus on hematoma expansion and early cerebral edema. In a retrospective study, we included all patients with primary ICH admitted to our center within 24-h from symptom onset from January 2014 to February 2015. We retrieved demographic and medical history data, Glasgow Coma Scale scores, blood cell counts, glucose, and C-reactive protein, and calculated NLR. We obtained hematoma volumes by computerized planimetry. Outcomes included independence at 90 days (modified Rankin scale 0-2), mortality at 30 days, significant hematoma expansion (> 33% or > 6 mL) and early cerebral edema causing significant midline shift (> 2.5 mm) at 24 h. We included 135 patients. NLR independently associated with independence at 90 days (adjusted odds ratio (aOR) 0.79, 95% CI 0.67-0.93, p = 0.006) significant cerebral edema (aOR 1.08, 95%CI 1.01-1.15, p = 0.016) but not hematoma expansion (aOR 0.99, 95%CI 0.94-1.04, p = 0.736). The severity of midline shift was positively correlated with NLR (adjusted beta = 0.08, 95% CI 0.05-0.11, p < 0.001). In ICH, an immediate and intense systemic inflammatory response reduces the likelihood of a better functional outcome at 90 days, which is more likely to be explained by perihematomal edema growth than due to a significant hematoma expansion. These findings could have implications in new treatment strategies and trial designs, which endpoints tend to target exclusively hematoma enlargement.
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