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      Platelet-to-Lymphocyte Ratio as a New Predictive Index of Neurological Outcomes in Patients with Acute Intracranial Hemorrhage: A Retrospective Study

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          Abstract

          Background

          Systemic inflammation plays a critical role in the pathophysiological process of intracranial hemorrhage (ICH). Recently, the platelet-to-lymphocyte ratio (PLR) has become a research focus that indicates inflammation in various diseases. Thus, this study aimed to investigate the predictive value of PLR in patients with acute ICH.

          Material/Methods

          This study was performed in a single teaching hospital. Glasgow coma scale at hospital discharge (GCS dis) and modified Rankin score (MRS) at 6 months were recorded as short-term and long-term neurological outcomes. Ordered and binary logistic regression methods were used to explore the associations.

          Results

          Finally, data on 183 ICH patients were included. A knot of PLR around 100 was detected and applied in the extended ordered logistic regression models. For PLR >100, PLR on ICU admission was significantly associated with worse GCS dis (from Model 1: OR: 1.004, 95% CI 1.001–1.007 to Model 4: OR: 1.006, 95% CI 1.002–1.009) while the PLR on Emergency Department (ED) admission was insignificant. For PLR ≤100, neither the PLR on ICU or ED admission was associated with GCS dis level. In the quartile grouping analysis, PLR Q2 was used as a reference level. Both Q3 and Q4 on ICU admission were significantly associated with lower GCS dis level (OR, 3.30; 95%CI 1.38–7.88; and OR, 3.79; 95%CI 1.54–9.33, respectively), while Q1 was insignificant. All 4 quartiles of PLR on ED admission were not associated with GCS dis.

          Conclusions

          Only higher PLR value on ICU admission but not on ED admission was associated with worse GCS dis.

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          Most cited references21

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          Guidelines for the Management of Spontaneous Intracerebral Hemorrhage: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association

          The aim of this guideline is to present current and comprehensive recommendations for the diagnosis and treatment of spontaneous intracerebral hemorrhage.
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            Inflammation after intracerebral hemorrhage.

            Intracerebral hemorrhage (ICH) is a devastating clinical event without effective therapies. Increasing evidence suggests that inflammatory mechanisms are involved in the progression of ICH-induced brain injury. Inflammation is mediated by cellular components, such as leukocytes and microglia, and molecular components, including prostaglandins, chemokines, cytokines, extracellular proteases, and reactive oxygen species. Better understanding of the role of the ICH-induced inflammatory response and its potential for modulation might have profound implications for patient treatment. In this review, a summary of the available literature on the inflammatory responses after ICH is presented along with discussion of some of the emerging opportunities for potential therapeutic strategies. In the near future, additional strategies that target inflammation could offer exciting new promise in the therapeutic approach to ICH.
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              Platelets in Inflammation and Atherogenesis

              Platelets contribute to processes beyond thrombus formation and may play a so far underestimated role as an immune cell in various circumstances. This review outlines immune functions of platelets in host defense, but also how they may contribute to mechanisms of infectious diseases. A particular emphasis is placed on the interaction of platelets with other immune cells. Furthermore, this article outlines the features of atherosclerosis as an inflammatory vascular disease highlighting the role of platelet crosstalk with cellular and soluble factors involved in atheroprogression. Understanding, how platelets influence these processes of vascular remodeling will shed light on their role for tissue homeostasis beyond intravascular thrombosis. Finally, translational implications of platelet-mediated inflammation in atherosclerosis are discussed.
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                Author and article information

                Journal
                Med Sci Monit
                Med. Sci. Monit
                Medical Science Monitor
                Medical Science Monitor : International Medical Journal of Experimental and Clinical Research
                International Scientific Literature, Inc.
                1234-1010
                1643-3750
                2018
                27 June 2018
                : 24
                : 4413-4420
                Affiliations
                Intensive Care Unit, Dongyang People’s Hospital, Dongyang, Zhejiang, P.R. China
                Author notes
                Corresponding Author: Yanfei Shen, e-mail: snow.shen@ 123456hotmail.com
                [A]

                Study Design

                [B]

                Data Collection

                [C]

                Statistical Analysis

                [D]

                Data Interpretation

                [E]

                Manuscript Preparation

                [F]

                Literature Search

                [G]

                Funds Collection

                Article
                910845
                10.12659/MSM.910845
                6052826
                29946059
                7ae3c736-07df-40c6-8b0f-bc2942e73431
                © Med Sci Monit, 2018

                This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International ( CC BY-NC-ND 4.0)

                History
                : 27 April 2018
                : 03 June 2018
                Categories
                Clinical Research

                glasgow coma scale,intracranial hemorrhages,lymphocyte count,platelet count

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