Neutrophil-to-albumin ratio as a predictor of mortality in patients with intracerebral hemorrhage: a multicenter retrospective cohort study

Abstract Background Intracerebral hemorrhage (ICH) is associated with a poor prognosis. The association between the neutrophil-to-albumin ratio (NAR) with mortality in patients with ICH remains underexplored. This study investigated the relationship between the NAR and mortality in patients with ICH...

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Main Authors: Jun Wan, Sen Zhang, Xiang Yuan, Yuyang Liu, Xin Cheng, Hao Liu, Fengrui Yang, Yinquan Ai, Xiaohong Luo, Yuting Zhong, Shiqiao Liu, Yu Zhang
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Neurology
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Online Access:https://doi.org/10.1186/s12883-025-04220-6
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author Jun Wan
Sen Zhang
Xiang Yuan
Yuyang Liu
Xin Cheng
Hao Liu
Fengrui Yang
Yinquan Ai
Xiaohong Luo
Yuting Zhong
Shiqiao Liu
Yu Zhang
author_facet Jun Wan
Sen Zhang
Xiang Yuan
Yuyang Liu
Xin Cheng
Hao Liu
Fengrui Yang
Yinquan Ai
Xiaohong Luo
Yuting Zhong
Shiqiao Liu
Yu Zhang
author_sort Jun Wan
collection DOAJ
description Abstract Background Intracerebral hemorrhage (ICH) is associated with a poor prognosis. The association between the neutrophil-to-albumin ratio (NAR) with mortality in patients with ICH remains underexplored. This study investigated the relationship between the NAR and mortality in patients with ICH. Methods A multicenter retrospective observational cohort study was conducted from January 2010 to June 2019. Participants were divided into four groups according to NAR quartiles at admission. Univariable and multivariable logistic regression analyses were used to evaluate the relationship between NAR and 90-day mortality. The predictive power of NAR was compared with neutrophil count and albumin levels using receiver operating characteristic (ROC) curve analysis. Results Patients in the highest NAR quartile had significantly greater odds of 90-day mortality (adjusted OR 1.74, 95% CI 1.27–2.39, p < 0.001) compared to those in the lowest quartile. The area under the curve (AUC) for NAR was 0.68, demonstrating superior discriminative ability compared to neutrophil count (AUC 0.64) and albumin (AUC 0.60). These findings were consistent across various subgroups, with multivariate analysis confirming the independent predictive value of NAR for mortality in patients with ICH. Conclusions Elevated NAR was independently associated with increased mortality in patients with ICH. NAR is a promising inflammatory marker that could aid in early risk assessment and guide management strategies for patients with ICH.
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spelling doaj-art-c5f84396d1cb4c28aa55c56a49c7e8dd2025-08-20T02:25:11ZengBMCBMC Neurology1471-23772025-05-012511810.1186/s12883-025-04220-6Neutrophil-to-albumin ratio as a predictor of mortality in patients with intracerebral hemorrhage: a multicenter retrospective cohort studyJun Wan0Sen Zhang1Xiang Yuan2Yuyang Liu3Xin Cheng4Hao Liu5Fengrui Yang6Yinquan Ai7Xiaohong Luo8Yuting Zhong9Shiqiao Liu10Yu Zhang11Center for Evidence-based Medicine, Affiliated Hospital of Chengdu UniversityCenter for Evidence-based Medicine, Affiliated Hospital of Chengdu UniversityCenter for Evidence-based Medicine, Affiliated Hospital of Chengdu UniversityCenter for Evidence-based Medicine, Affiliated Hospital of Chengdu UniversityDepartment of Neurosurgery, West Hospital of ChinaCenter for Evidence-based Medicine, Affiliated Hospital of Chengdu UniversityCenter for Evidence-based Medicine, Affiliated Hospital of Chengdu UniversityCenter for Evidence-based Medicine, Affiliated Hospital of Chengdu UniversityCenter for Evidence-based Medicine, Affiliated Hospital of Chengdu UniversityCenter for Evidence-based Medicine, Affiliated Hospital of Chengdu UniversityCenter for Evidence-based Medicine, Affiliated Hospital of Chengdu UniversityCenter for Evidence-based Medicine, Affiliated Hospital of Chengdu UniversityAbstract Background Intracerebral hemorrhage (ICH) is associated with a poor prognosis. The association between the neutrophil-to-albumin ratio (NAR) with mortality in patients with ICH remains underexplored. This study investigated the relationship between the NAR and mortality in patients with ICH. Methods A multicenter retrospective observational cohort study was conducted from January 2010 to June 2019. Participants were divided into four groups according to NAR quartiles at admission. Univariable and multivariable logistic regression analyses were used to evaluate the relationship between NAR and 90-day mortality. The predictive power of NAR was compared with neutrophil count and albumin levels using receiver operating characteristic (ROC) curve analysis. Results Patients in the highest NAR quartile had significantly greater odds of 90-day mortality (adjusted OR 1.74, 95% CI 1.27–2.39, p < 0.001) compared to those in the lowest quartile. The area under the curve (AUC) for NAR was 0.68, demonstrating superior discriminative ability compared to neutrophil count (AUC 0.64) and albumin (AUC 0.60). These findings were consistent across various subgroups, with multivariate analysis confirming the independent predictive value of NAR for mortality in patients with ICH. Conclusions Elevated NAR was independently associated with increased mortality in patients with ICH. NAR is a promising inflammatory marker that could aid in early risk assessment and guide management strategies for patients with ICH.https://doi.org/10.1186/s12883-025-04220-6Intracerebral hemorrhageNeutrophil-to-albumin ratioMortality
spellingShingle Jun Wan
Sen Zhang
Xiang Yuan
Yuyang Liu
Xin Cheng
Hao Liu
Fengrui Yang
Yinquan Ai
Xiaohong Luo
Yuting Zhong
Shiqiao Liu
Yu Zhang
Neutrophil-to-albumin ratio as a predictor of mortality in patients with intracerebral hemorrhage: a multicenter retrospective cohort study
BMC Neurology
Intracerebral hemorrhage
Neutrophil-to-albumin ratio
Mortality
title Neutrophil-to-albumin ratio as a predictor of mortality in patients with intracerebral hemorrhage: a multicenter retrospective cohort study
title_full Neutrophil-to-albumin ratio as a predictor of mortality in patients with intracerebral hemorrhage: a multicenter retrospective cohort study
title_fullStr Neutrophil-to-albumin ratio as a predictor of mortality in patients with intracerebral hemorrhage: a multicenter retrospective cohort study
title_full_unstemmed Neutrophil-to-albumin ratio as a predictor of mortality in patients with intracerebral hemorrhage: a multicenter retrospective cohort study
title_short Neutrophil-to-albumin ratio as a predictor of mortality in patients with intracerebral hemorrhage: a multicenter retrospective cohort study
title_sort neutrophil to albumin ratio as a predictor of mortality in patients with intracerebral hemorrhage a multicenter retrospective cohort study
topic Intracerebral hemorrhage
Neutrophil-to-albumin ratio
Mortality
url https://doi.org/10.1186/s12883-025-04220-6
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