Neutrophil-to-lymphocyte ratio and systemic inflammation response index as biomarkers for the clinical outcomes of intracerebral hemorrhagic stroke patients: a prospective cohort study

PurposeTo examine the associations between the neutrophil-to-lymphocyte ratio (NLR), systemic inflammation response index (SIRI) and clinical outcomes of intracerebral hemorrhagic (ICH) stroke patients.MethodsThis prospective cohort study recruited and investigated longitudinally 294 ICH stroke pati...

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Main Authors: Ziyi Hu, Wei Zhu, Chaofeng Fan, Yan Jiang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1616128/full
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author Ziyi Hu
Wei Zhu
Chaofeng Fan
Yan Jiang
author_facet Ziyi Hu
Wei Zhu
Chaofeng Fan
Yan Jiang
author_sort Ziyi Hu
collection DOAJ
description PurposeTo examine the associations between the neutrophil-to-lymphocyte ratio (NLR), systemic inflammation response index (SIRI) and clinical outcomes of intracerebral hemorrhagic (ICH) stroke patients.MethodsThis prospective cohort study recruited and investigated longitudinally 294 ICH stroke patients in a general tertiary hospital in Sichuan Province, China at baseline (admission), 1-month post-discharge, 3-month post-discharge and 6-month post-discharge from January 2020 to January 2022. We calculated the NLR and SIRI from blood samples collected at baseline. The Mann–Whitney test, logistic regression analysis and receiver operating characteristic (ROC) analysis were performed to evaluate differences in the NLR and SIRI between hemorrhagic stroke patients at three follow-up time points. The interaction between these variables was evaluated via multiplicative and additive interaction models.ResultsOur study revealed that the cut-off values of the NLR and SIRI to predict the clinical outcomes were determined to be 6 and 4, respectively. NLR > 6 (OR 2.202, 95% CI: 1.094–4.430) and SIRI>4 (OR 2.056, 95% CI: 1.065–3.968) were associated with increased risks for poor clinical outcomes at 1-month post-discharge. SIRI>4 (OR 2.428, 95% CI: 1.389–4.243) were associated with increased risks for poor clinical outcomes at 3-month post-discharge. NLR > 6 (OR 1.978, 95% CI: 1.093–3.580) were associated with increased risks for poor clinical outcomes at 6-month post-discharge.ConclusionThe NLR and SIRI did not have an additive effect on the clinical outcome at 1-month post-discharge. Our findings indicate that high NLRs and SIRIs, particularly NLR > 6 and SIRI>4, are associated with poor clinical outcomes in ICH stroke patients.
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spelling doaj-art-12417b1ebca64fac950de71eca1d3c4c2025-08-20T03:12:38ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-07-011610.3389/fneur.2025.16161281616128Neutrophil-to-lymphocyte ratio and systemic inflammation response index as biomarkers for the clinical outcomes of intracerebral hemorrhagic stroke patients: a prospective cohort studyZiyi Hu0Wei Zhu1Chaofeng Fan2Yan Jiang3Department of Nursing, West China Hospital/West China School of Nursing, Sichuan University, Chengdu, ChinaDepartment of Neurosurgery, West China Hospital/West China School of Nursing, Sichuan University, Chengdu, ChinaDepartment of Neurosurgery, West China Hospital/West China School of Nursing, Sichuan University, Chengdu, ChinaDepartment of Nursing, West China Hospital/West China School of Nursing, Sichuan University, Chengdu, ChinaPurposeTo examine the associations between the neutrophil-to-lymphocyte ratio (NLR), systemic inflammation response index (SIRI) and clinical outcomes of intracerebral hemorrhagic (ICH) stroke patients.MethodsThis prospective cohort study recruited and investigated longitudinally 294 ICH stroke patients in a general tertiary hospital in Sichuan Province, China at baseline (admission), 1-month post-discharge, 3-month post-discharge and 6-month post-discharge from January 2020 to January 2022. We calculated the NLR and SIRI from blood samples collected at baseline. The Mann–Whitney test, logistic regression analysis and receiver operating characteristic (ROC) analysis were performed to evaluate differences in the NLR and SIRI between hemorrhagic stroke patients at three follow-up time points. The interaction between these variables was evaluated via multiplicative and additive interaction models.ResultsOur study revealed that the cut-off values of the NLR and SIRI to predict the clinical outcomes were determined to be 6 and 4, respectively. NLR > 6 (OR 2.202, 95% CI: 1.094–4.430) and SIRI>4 (OR 2.056, 95% CI: 1.065–3.968) were associated with increased risks for poor clinical outcomes at 1-month post-discharge. SIRI>4 (OR 2.428, 95% CI: 1.389–4.243) were associated with increased risks for poor clinical outcomes at 3-month post-discharge. NLR > 6 (OR 1.978, 95% CI: 1.093–3.580) were associated with increased risks for poor clinical outcomes at 6-month post-discharge.ConclusionThe NLR and SIRI did not have an additive effect on the clinical outcome at 1-month post-discharge. Our findings indicate that high NLRs and SIRIs, particularly NLR > 6 and SIRI>4, are associated with poor clinical outcomes in ICH stroke patients.https://www.frontiersin.org/articles/10.3389/fneur.2025.1616128/fullintracerebral hemorrhagic strokeMRSneutrophil-to-lymphocyte ratiosystemic inflammation response indexprognosis
spellingShingle Ziyi Hu
Wei Zhu
Chaofeng Fan
Yan Jiang
Neutrophil-to-lymphocyte ratio and systemic inflammation response index as biomarkers for the clinical outcomes of intracerebral hemorrhagic stroke patients: a prospective cohort study
Frontiers in Neurology
intracerebral hemorrhagic stroke
MRS
neutrophil-to-lymphocyte ratio
systemic inflammation response index
prognosis
title Neutrophil-to-lymphocyte ratio and systemic inflammation response index as biomarkers for the clinical outcomes of intracerebral hemorrhagic stroke patients: a prospective cohort study
title_full Neutrophil-to-lymphocyte ratio and systemic inflammation response index as biomarkers for the clinical outcomes of intracerebral hemorrhagic stroke patients: a prospective cohort study
title_fullStr Neutrophil-to-lymphocyte ratio and systemic inflammation response index as biomarkers for the clinical outcomes of intracerebral hemorrhagic stroke patients: a prospective cohort study
title_full_unstemmed Neutrophil-to-lymphocyte ratio and systemic inflammation response index as biomarkers for the clinical outcomes of intracerebral hemorrhagic stroke patients: a prospective cohort study
title_short Neutrophil-to-lymphocyte ratio and systemic inflammation response index as biomarkers for the clinical outcomes of intracerebral hemorrhagic stroke patients: a prospective cohort study
title_sort neutrophil to lymphocyte ratio and systemic inflammation response index as biomarkers for the clinical outcomes of intracerebral hemorrhagic stroke patients a prospective cohort study
topic intracerebral hemorrhagic stroke
MRS
neutrophil-to-lymphocyte ratio
systemic inflammation response index
prognosis
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1616128/full
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