Analysis of biochemical laboratory values to determine etiology and prognosis in patients with subarachnoid hemorrhage: a clinical study

ABSTRACT

Objectives: The aim of this study was to establish prognostic and predictive markers in patients with subarachnoid hemorrhage (SAH) using simple laboratory methods.

Methods: A retrospective examination was made of patients with SAH diagnosed secondary to isolated head trauma, isolated anterior communicating artery aneurysm rupture, and angiography-negative SAH. Age, gender, Glasgow Coma Scale (GCS) scores, and Fisher’s grade scores, Glasgow Outcome Scale (GOS) scores, leukocyte count, neutrophil count, lymphocyte count, platelet count, neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio results (PLR) were evaluated.

Results: NLR and PLR values, which were similar in patients with spontaneous SAH, were significantly high in patients with traumatic SAH. NLR and PLR values could be 80% sensitive and 75% specific for distinguishing traumatic SAH from spontaneous SAH. Eosinophil count was lower in patients with angiography-negative SAH and patients with aneurysmal SAH than in patients with traumatic SAH. Initially measured GCS score, Fisher’s grade score, eosinophil, neutrophil and lymphocyte counts could be prognostic in all patients with SAH. Moreover, it was concluded that the initially measured number of eosinophils might be directly related to patient prognosis. The eosinophil count was generally found to be high in traumatic SAH patients and it was observed that this parameter could be predictive for these patients. Lymphocyte count and NLR values could be prognostic markers in patients with angiography-negative SAH.

Conclusion: NLR, PLR and eosinophil count values could be predictive for etiological factors (traumatic SAH or spontaneous SAH) of patients who were admitted unconscious to the emergency room with SAH detected on radiological imaging.

KEYWORDS:

• Subarachnoid hemorrhage
• neutrophil to lymphocyte ratio
• platelet to lymphocyte ratio
• eosiophil
• leukocyte
• outcome
• prognosis

Acknowledgments

The authors would like to thank Mikail Inal, MD, Associate Professor, for his invaluable assistance in the interpretation of the radiological images in this study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Bulent Bakar

Bulent Bakar MD, Associate Professor, is a graduate of Hacettepe University Medical School in 1996. He trained in neurosurgery at the Hacettepe University Medical School 1999 to 2005 years. He is an associate professor of medicine at the Kirikkale University Medical School, in the Division of Neurosurgery, Turkey since 2009. He divides his time between clinical practice, training and consulting, scholarly writing and research since 2005. He has conducted several studies of stroke, faield back syndrome, neuro-oncology and neurotrauma.