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İskemik ve Hemorajik Serebrovasküler Olay Tanılı Hastalarda Kan Parametrelerinin Prognostik Değeri

Year 2024, Volume: 6 Issue: 3, 119 - 122, 31.12.2024
https://doi.org/10.55994/ejcc.1608086

Abstract

GİRİŞ
Serebral enfarktüs, intraserebral kanama (ICH) ve subaraknoid kanama (SAK) sonucu ortaya çıkan akut nörolojik yaralanma inmesi olarak tanımlanır. İnme olgularının %80-85'i iskemik gruptadır. Hemorajik inme bu olguların yaklaşık %10-30'undan sorumludur. Çalışmalar, ortaya çıkan inflamatuar yanıtın iskemik beyin hasarını ve nörolojik disfonksiyonu şiddetlendirdiğini göstermiştir.

GEREÇ VE YÖNTEM
İstanbul'da üçüncü basamak bir devlet hastanesine son altı ay içinde başvuran ve inme tanısı alan hastalar retrospektif olarak incelendi. Çalışmada inme tanısı konulan 116 hastanın başvuru anında alınan kan örnekleri incelendi ve tam kan sayımında nötrofil ve lenfosit değerleri kullanıldı. Nötrofil/Lenfosit oranları (NLO) bu değerler çıkarılarak hesaplandı. Hastaların hastanede kalış süreleri kaydedildi. Olguların NLO değerlerinin hastanede kalış süreleri ile korelasyonu incelendi.

BULGULAR
Çalışmaya dahil edilen 116 hastanın 100'ünde iskemik inme, 16'sında hemorajik inme vardı. İncelenen olguların 63'ü erkek, 53'ü kadındı. Yaş ortalaması 71,6±11,6 yıldı. Hemorajik inme ve iskemik inme grupları arasında yaş ve cinsiyet açısından istatistiksel olarak anlamlı fark yoktu. Hastaların hastanede kalış süreleri ile NLO değerleri arasındaki korelasyonu inceledik. İskemik inme ve hemorajik inme hasta gruplarında yatış süresi ile NLO arasında istatistiksel olarak anlamlı bir ilişki olmadığını saptadık. Benzer şekilde, hastanede kalış süresi ve NLO düzeylerini incelediğimizde, zayıf ve istatistiksel olarak anlamlı bir korelasyon olmadığını gösterdik.

SONUÇ
Literatürde yüksek nötrofil ve düşük lenfosit değerlerinin mortalite ve morbidite üzerine olumsuz etkisi olduğunu gösteren çok sayıda çalışma olmasına rağmen, bizim çalışmamızdaki gibi bir etkisi gösterilememiş çalışmalar da mevcuttur.

References

  • 1. Sacco, R. L., Kasner, S. E., Broderick, J. P., Caplan, L. R., Connors, J. J., Culebras, A., ... & Vinters, H. V. (2013). An updated definition of stroke for the 21st century: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 44(7), 2064-2089.
  • 2. Allen, C. L., & Bayraktutan, U. (2009). Oxidative stress and its role in the pathogenesis of ischaemic stroke. International journal of stroke, 4(6), 461-470.
  • 3. Chamorro, A., & Hallenbeck, J. (2006). The harms and benefits of inflammatory and immune responses in vascular disease. Stroke, 37(2), 291-293.
  • 4. Xue, J., Huang, W., Chen, X., Li, Q., Cai, Z., Yu, T., & Shao, B. (2017). Neutrophil-to-lymphocyte ratio is a prognostic marker in acute ischemic stroke. Journal of Stroke and Cerebrovascular Diseases, 26(3), 650-657.
  • 5. Rodrigues, S. F., & Granger, D. N. (2014). Leukocyte-mediated tissue injury in ischemic stroke. Current medicinal chemistry, 21(19), 2130-2137.
  • 6. Buck, B. H., Liebeskind, D. S., Saver, J. L., Bang, O. Y., Yun, S. W., Starkman, S., ... & Ovbiagele, B. (2008). Early neutrophilia is associated with volume of ischemic tissue in acute stroke. Stroke, 39(2), 355-360.
  • 7. Lattanzi, S., Brigo, F., Trinka, E., Cagnetti, C., Di Napoli, M., & Silvestrini, M. (2019). Neutrophil-to-lymphocyte ratio in acute cerebral hemorrhage: a system review. Translational stroke research, 10, 137-145.
  • 8. Nasr, N., Ruidavets, J. B., Arnal, J. F., Sie, P., & Larrue, V. (2009). Association of neutrophil count with microembolization in patients with symptomatic carotid artery stenosis. Atherosclerosis, 207(2), 519-523.
  • 9. Desertler, B. S. (2005). Leukocytosis and ischemic vascular disease morbidity and mortality: is it time to intervene?. Arteriosclerosis, thrombosis, and vascular biology, 25(4), 658-670.
  • 10. Küçük, E., Kocayiğit, İ., Günel, C., & Regular, H. (2016). Neutrophil-to-lymphocyte ratio in occlusive vascular diseases: the literature review of the past 10 years. World journal of emergency medicine, 7(3), 165.
  • 11. Li, W., Hou, M., Ding, Z., Liu, X., Shao, Y., & Li, X. (2021). Prognostic value of neutrophil-to-lymphocyte ratio in stroke: a systematic review and meta-analysis. Frontiers in Neurology, 12, 686983.
  • 12. Zhang, J., Ren, Q., Song, Y., He, M., Zeng, Y., Liu, Z., & Xu, J. (2017). Prognostic role of neutrophil–lymphocyte ratio in patients with acute ischemic stroke. Medicine, 96(45), e8624.
  • 13. Kim, J., Song, T. J., Park, J. H., Lee, H. S., Nam, C. M., Nam, H. S., ... & Heo, J. H. (2012). Different prognostic value of white blood cell subtypes in patients with acute cerebral infarction. Atherosclerosis, 222(2), 464-467.
  • 14. Tokgöz, S., Keskin, S., Kayrak, M., Seyithanoğlu, A., & Oğmegül, A. (2014). Is neutrophil/lymphocyte ratio predict to short-term mortality in acute cerebral infarct independently from infarct volume?. Journal of Stroke and Cerebrovascular Diseases, 23(8), 2163-2168.
  • 15. Lattanzi, S., Cagnetti, C., Provinciali, L., & Silvestrini, M. (2017). Neutrophil-to-lymphocyte ratio and neurological deterioration following acute cerebral hemorrhage. Oncotarget, 8(34), 57489.
  • 16. Wang, F., Hu, S., Ding, Y., Ju, X., Wang, L., Lu, Q., & Wu, X. (2016). Neutrophil-to-lymphocyte ratio and 30-day mortality in patients with acute intracerebral hemorrhage. Journal of Stroke and Cerebrovascular Diseases, 25(1), 182-187.
  • 17. Gökhan, S., Özhasenekler, A., Durgun, H. M., Akil, E., Üstündağ, M., & Orak, M. (2013). Neutrophil lymphocyte ratios in stroke subtypes and transient ischemic attack. Age (mean±SD; y), 67, 11-13.
  • 18. Tokgoz, S., Kayrak, M., Akpinar, Z., Seyithanoğlu, A., Güney, F., & Walker, B. (2013). Neutrophil lymphocyte ratio as a predictor of stroke. Journal of Stroke and Cerebrovascular Diseases, 22(7), 1169-1174.
  • 19. Yilmaz, E., Bayram Kaçar, A., Bozpolat, A., Harmsiz, G., Gorkem, B. S., Karakukcu, M., ... & Unal, E. (2018). The relationship between hematological parameters and prognosis of children with acute ischemic stroke. Child's Nervous System, 34, 655-661.
  • 20. Arıkan, C., Çınaroğlu, O. S., Efgan, M. G., Kanter, E., & Bora, E. S. (2023). A new adjunct in the differentiation of encephalitis and meningitis after negative cerebrospinal fluid culture: systemic inflammatory immune index. The European Research Journal, 9(5), 1129-1134.
  • 21. Bhat, T., Teli, S., Rijal, J., Bhat, H., Raza, M., Khoueiry, G., ... & Costantino, T. (2013). Neutrophil to lymphocyte ratio and cardiovascular diseases: a review. Expert review of cardiovascular therapy, 11(1), 55-59.

Prognostic Value of Blood Parameters in Patients Diagnosed with Ischemic and Hemorrhagic Cerebrovascular Events

Year 2024, Volume: 6 Issue: 3, 119 - 122, 31.12.2024
https://doi.org/10.55994/ejcc.1608086

Abstract

INTRODUCTION
Cerebral infarction is defined as an acute neurological injury stroke that occurs as a result of intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH). 80-85% of stroke cases are ischemic group. Hemorrhagic stroke is responsible for approximately 10-30% of these cases. Studies have shown that the inflammatory response that occurs exacerbates ischemic brain injury and neurological dysfunction.

MATERIALS AND METHODS
Patients who were admitted to a tertiary state hospital in Istanbul in the last six months and diagnosed with stroke were retrospectively analyzed. Blood samples taken at the time of admission of 116 patients with stroke diagnosed in the study were examined and neutrophil and lymphocyte values in the complete blood count were used in the study. Neutrophil/Lymphocyte ratios (NLR) were calculated by subtracting these values. Hospitalization times of the patients were recorded. The correlation of NLR values of the cases with the length of hospital stay was examined.

RESULTS
Of the 116 patients included in the study, 100 had ischemic stroke and 16 had hemorrhagic stroke. Of the cases examined, 63 were male and 53 were female. The mean age was 71.6±11.6 years. There was no statistically significant difference between hemorrhagic stroke and ischemic stroke groups in terms of age and gender. We examined the correlation between the length of hospital stay and NLR values of the patients. We found that there was no statistically significant correlation between length of stay and NLR in ischemic stroke and hemorrhagic stroke patient groups. Likewise, when we examined the length of hospitalization and NLR levels, we showed that there was no weak and statistically significant correlation.

CONCLUSION
Although there are many studies in the literature showing that high neutrophil and low lymphocyte values have a negative effect on mortality and morbidity, there are also studies that have not been shown to have an effect as in our study.

References

  • 1. Sacco, R. L., Kasner, S. E., Broderick, J. P., Caplan, L. R., Connors, J. J., Culebras, A., ... & Vinters, H. V. (2013). An updated definition of stroke for the 21st century: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 44(7), 2064-2089.
  • 2. Allen, C. L., & Bayraktutan, U. (2009). Oxidative stress and its role in the pathogenesis of ischaemic stroke. International journal of stroke, 4(6), 461-470.
  • 3. Chamorro, A., & Hallenbeck, J. (2006). The harms and benefits of inflammatory and immune responses in vascular disease. Stroke, 37(2), 291-293.
  • 4. Xue, J., Huang, W., Chen, X., Li, Q., Cai, Z., Yu, T., & Shao, B. (2017). Neutrophil-to-lymphocyte ratio is a prognostic marker in acute ischemic stroke. Journal of Stroke and Cerebrovascular Diseases, 26(3), 650-657.
  • 5. Rodrigues, S. F., & Granger, D. N. (2014). Leukocyte-mediated tissue injury in ischemic stroke. Current medicinal chemistry, 21(19), 2130-2137.
  • 6. Buck, B. H., Liebeskind, D. S., Saver, J. L., Bang, O. Y., Yun, S. W., Starkman, S., ... & Ovbiagele, B. (2008). Early neutrophilia is associated with volume of ischemic tissue in acute stroke. Stroke, 39(2), 355-360.
  • 7. Lattanzi, S., Brigo, F., Trinka, E., Cagnetti, C., Di Napoli, M., & Silvestrini, M. (2019). Neutrophil-to-lymphocyte ratio in acute cerebral hemorrhage: a system review. Translational stroke research, 10, 137-145.
  • 8. Nasr, N., Ruidavets, J. B., Arnal, J. F., Sie, P., & Larrue, V. (2009). Association of neutrophil count with microembolization in patients with symptomatic carotid artery stenosis. Atherosclerosis, 207(2), 519-523.
  • 9. Desertler, B. S. (2005). Leukocytosis and ischemic vascular disease morbidity and mortality: is it time to intervene?. Arteriosclerosis, thrombosis, and vascular biology, 25(4), 658-670.
  • 10. Küçük, E., Kocayiğit, İ., Günel, C., & Regular, H. (2016). Neutrophil-to-lymphocyte ratio in occlusive vascular diseases: the literature review of the past 10 years. World journal of emergency medicine, 7(3), 165.
  • 11. Li, W., Hou, M., Ding, Z., Liu, X., Shao, Y., & Li, X. (2021). Prognostic value of neutrophil-to-lymphocyte ratio in stroke: a systematic review and meta-analysis. Frontiers in Neurology, 12, 686983.
  • 12. Zhang, J., Ren, Q., Song, Y., He, M., Zeng, Y., Liu, Z., & Xu, J. (2017). Prognostic role of neutrophil–lymphocyte ratio in patients with acute ischemic stroke. Medicine, 96(45), e8624.
  • 13. Kim, J., Song, T. J., Park, J. H., Lee, H. S., Nam, C. M., Nam, H. S., ... & Heo, J. H. (2012). Different prognostic value of white blood cell subtypes in patients with acute cerebral infarction. Atherosclerosis, 222(2), 464-467.
  • 14. Tokgöz, S., Keskin, S., Kayrak, M., Seyithanoğlu, A., & Oğmegül, A. (2014). Is neutrophil/lymphocyte ratio predict to short-term mortality in acute cerebral infarct independently from infarct volume?. Journal of Stroke and Cerebrovascular Diseases, 23(8), 2163-2168.
  • 15. Lattanzi, S., Cagnetti, C., Provinciali, L., & Silvestrini, M. (2017). Neutrophil-to-lymphocyte ratio and neurological deterioration following acute cerebral hemorrhage. Oncotarget, 8(34), 57489.
  • 16. Wang, F., Hu, S., Ding, Y., Ju, X., Wang, L., Lu, Q., & Wu, X. (2016). Neutrophil-to-lymphocyte ratio and 30-day mortality in patients with acute intracerebral hemorrhage. Journal of Stroke and Cerebrovascular Diseases, 25(1), 182-187.
  • 17. Gökhan, S., Özhasenekler, A., Durgun, H. M., Akil, E., Üstündağ, M., & Orak, M. (2013). Neutrophil lymphocyte ratios in stroke subtypes and transient ischemic attack. Age (mean±SD; y), 67, 11-13.
  • 18. Tokgoz, S., Kayrak, M., Akpinar, Z., Seyithanoğlu, A., Güney, F., & Walker, B. (2013). Neutrophil lymphocyte ratio as a predictor of stroke. Journal of Stroke and Cerebrovascular Diseases, 22(7), 1169-1174.
  • 19. Yilmaz, E., Bayram Kaçar, A., Bozpolat, A., Harmsiz, G., Gorkem, B. S., Karakukcu, M., ... & Unal, E. (2018). The relationship between hematological parameters and prognosis of children with acute ischemic stroke. Child's Nervous System, 34, 655-661.
  • 20. Arıkan, C., Çınaroğlu, O. S., Efgan, M. G., Kanter, E., & Bora, E. S. (2023). A new adjunct in the differentiation of encephalitis and meningitis after negative cerebrospinal fluid culture: systemic inflammatory immune index. The European Research Journal, 9(5), 1129-1134.
  • 21. Bhat, T., Teli, S., Rijal, J., Bhat, H., Raza, M., Khoueiry, G., ... & Costantino, T. (2013). Neutrophil to lymphocyte ratio and cardiovascular diseases: a review. Expert review of cardiovascular therapy, 11(1), 55-59.
There are 21 citations in total.

Details

Primary Language English
Subjects Emergency Medicine
Journal Section Original Articles
Authors

Sema Ayten 0000-0001-8417-331X

Publication Date December 31, 2024
Submission Date December 27, 2024
Acceptance Date December 30, 2024
Published in Issue Year 2024 Volume: 6 Issue: 3

Cite

AMA Ayten S. Prognostic Value of Blood Parameters in Patients Diagnosed with Ischemic and Hemorrhagic Cerebrovascular Events. Eurasian j Crit Care. December 2024;6(3):119-122. doi:10.55994/ejcc.1608086

Indexing and Abstracting

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