Evidence map›Paper›PMID 33587200›Full record

SynthesisNeurosurgical review2021

Is neutrophil-lymphocyte ratio a useful tool for predicting outcome in subarachnoid hemorrhage? A systematic review.

Artur Nóbrega Lima Rodrigues de Morais, Victor Matheus Ribeiro Baylão, Tamires Martins Silva, Alexandra Gomes Dos Santos, Mayara Azevedo, Adilson J M de Oliveira

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Neurosurgical review, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 2 pooled it
3.2field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 36 citations in OpenAlex.

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  16. Postoperative neutrophil-to-lymphocyte ratio variation is associated with chronic subdural hematoma recurrence.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 2 countries.

Artur Nóbrega Lima Rodrigues de MoraisHospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, PO Box: 02010-000, R. Voluntários da Pátria, 764, São Paulo, Brazil. a.morais@hc.fm.usp.br.ORCID http://orcid.org/0000-0002-1270-1520
Victor Matheus Ribeiro BaylãoFaculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Tamires Martins SilvaFaculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Alexandra Gomes Dos SantosFaculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Mayara AzevedoFaculdade de Ciências da Universidade Federal do ABC, São Bernardo do Campo, Brazil.
Adilson J M de OliveiraHospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, PO Box: 02010-000, R. Voluntários da Pátria, 764, São Paulo, Brazil.
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo · BRUniversidade Federal do ABC · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Ruptured intracranial aneurysms, as the leading cause of spontaneous subarachnoid hemorrhage (aSAH), represents an emergency with high morbi-mortality. The comprehension of the underlying pathology that involves inflammatory and immune responses, through the neutrophil-to-lymphocyte ratio (NLR), could help to predict complications such as delayed cerebral ischemia (DCI) or rebleeding and the functional outcome. Systematic review of English-based literature through PubMed and Biblioteca Vitural em Saúde (BVS) to find papers discussing the use of NLR in the aSAH setting. Area-under-curve (AUC) of receiver operating characteristics (ROC), cutoff value, sensitivity, and specificity were retrieved. From 53 articles included, 4 papers were evaluated after exclusion criteria. Rebleeding could be predicted with a NLR cutoff value of 9.88 (sensitivity 72.3%, specificity 63.3%). The mean cutoff value for DCI was 12.85, with sensitivity 66.3% and specificity 75.8%. Finally, a worse 3-month functional outcome could be predicted with a mean sensitivity of 73.3% and a mean specificity of 54%. NLR is a new issue in scientific community, especially neurosurgery. The current understanding points to a multifactorial process after aSAH that emerges as alterations on the NLR. As a measurement readily available and cost-effect after admission of the patient, its use signals that patients that need expedite surgical treatment or more aggressive treatment for vasospasm. As other medical subspecialties already use this ratio to predict outcomes, the literature reviewed by this paper constitute the earliest clues that higher NLR predicts re-bleeding, DCI, and functional outcome.

Indexed as

Brain IschemiaIntracranial AneurysmSubarachnoid HemorrhageHumansLymphocytesNeutrophilsAneurismal subarachnoid hemorrhageDelayed cerebral ischemiaFunctional outcomeNeutrophil-to-lymphocyte ratio

Identifiers

PMID33587200
OpenAlexW3130805416

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.