Anevrizmatik subaraknoid kanama geçiren hastaların fonksiyonel iyileşmesinin değerlendirmesinde nötrofil-lenfosit oranının önemi

Abstract

Amaç: Çalışmamızda, anevrizmatik subaraknoid kanama (SAK) nedeni ile cerrahi klipleme ameliyatı geçiren hastaların ameliyat sonrası üçüncü aydaki Modifiye Rankin Skala'sını (MRS) ile nötrofil-lenfosit oranı (NLO) arasındaki korelasyonun belirlenmesi ve NLO'nının hastaların sağkalımı üzerine etkisinin değerlendirilmesi amaçlanmıştır Gereç ve Yöntemler: Bu retrospektif, gözlemsel ve multisentrik çalışmaya, anevrizma nedeni ile subaraknoid kanama (SAK) geçiren hastalar dahil edildi. Hastalar MRS değerlerine göre iki gruba ayrıldı; grup 1, MRS değeri 0 ve grup 2, MRS değeri 1-2. Hastaların demografik verileri, sigara tüketimi, anevrizma boyutu, Hunt-Hess derecesi (H-H) I-II ve Fisher derecesi, MRS ve NLO değerleri kayıt altına alındı. Hastaların ilk başvuru sırasındaki NLO'nının 3. aydaki MRS değerleri arasındaki ilişki karşılaştırıldı. Bulgular: Ortalama NLO'nı MRS değeri düşük olan hastalarda 4.75±1.57 (birim yazmak lazım) iken MRS değeri yüksek olan hastalarda 7,22±3,54 olarak saptandı (p <0.05). MRS değeri yüksek olan hastalarda NLO'nının, MRS değeri düşük olan hastalarla karşılaştırıldığında, istatistiksel olarak anlamlı bir şekilde daha yüksek olduğu tespit edildi (p <0.001). Sonuç: Anevrizmatik SAK sonrası meydana gelen inflamasyonun şiddeti prognoz üzerinde etkili olduğu bilinmektedir. Bu nedenle inflamatuvar yanıtın şiddetiyle ilişkili olan NLO'nının SAK geçiren hastaların klinik takip ve prognozunu tahmin etmede önemli bir belirteç olabileceği düşüncesindeyiz.

Keywords

• Anevrizmatik subaraknoid kanama
• Nötrofil-lenfosit oranı
• Fonksiyonel iyileşme rankin skalası

The importance of neutrophil-lymphocyte ratio on the functional recovery of the patients with aneurysmal subarachnoid hemorrhage

Abstract

Objective In our study, it was aimed to determine the correlation between the Modified Rankin Scale (MRS) and the neutrophil-lymphocyte ratio (NLR) at the third month postoperatively in patients who underwent surgical clipping due to aneurysmatic subarachnoid hemorrhage (SAH) and to evaluate the effect of NLR on the survival of the patients. Material and Methods Patients with subarachnoid hemorrhage (SAH) due to aneurysm were included in this retrospective, observational and multicentric study. The patients were divided into two groups according to their MRS values; group 1, MRS value 0 and group 2, MRS value 1-2. Demographic data of the patients, smoking consumption, aneurysm size, Hunt-Hess grade (H-H) I-II and Fisher grade, MRS and NLR values were recorded. The relationship between the patients' NLR at the first admission and the MRS values at the 3rd month was compared. Results While the mean NLR was 4.75±1.57 in patients with low MRS value, it was 7.22±3.54 in patients with high MRS value (p <0.05). NLR was found to be statistically significantly higher in patients with high MRS compared to patients with low MRS value (p <0.001). Conclusion It is known that the severity of inflammation after aneurysmatic SAH is effective on prognosis. Therefore, we think that NLR, which is related to the severity of the inflammatory response, may be an important marker in predicting the clinical follow-up and prognosis of patients with SAH.

Keywords

• aneurysmal subarachnoid hemorrhage
• The neutrophil-lymphocyte ratio
• functional recovery in Rankin scala

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