The Monocyte-to-Lymphocyte Ratio at Hospital Admission Is a Novel Predictor for Acute Traumatic Intraparenchymal Hemorrhage Expansion after Cerebral Contusion
Purpose. To explore the potential of monocyte-to-lymphocyte ratio (MLR) at hospital admission for predicting acute traumatic intraparenchymal hematoma (tICH) expansion in patients with cerebral contusion. Patients and Methods. This multicenter, observational study included patients with available at...
Saved in:
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-01-01
|
| Series: | Mediators of Inflammation |
| Online Access: | http://dx.doi.org/10.1155/2020/5483981 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832552817854775296 |
|---|---|
| author | Jiangtao Sheng Tian Li Dongzhou Zhuang Shirong Cai Jinhua Yang Faxiu Ding Xiaoxuan Chen Fei Tian Mindong Huang Lianjie Li Kangsheng Li Weiqiang Chen |
| author_facet | Jiangtao Sheng Tian Li Dongzhou Zhuang Shirong Cai Jinhua Yang Faxiu Ding Xiaoxuan Chen Fei Tian Mindong Huang Lianjie Li Kangsheng Li Weiqiang Chen |
| author_sort | Jiangtao Sheng |
| collection | DOAJ |
| description | Purpose. To explore the potential of monocyte-to-lymphocyte ratio (MLR) at hospital admission for predicting acute traumatic intraparenchymal hematoma (tICH) expansion in patients with cerebral contusion. Patients and Methods. This multicenter, observational study included patients with available at-hospital admission (baseline) and follow-up computed tomography for volumetric analysis (retrospective development cohort: 1146 patients; prospective validation cohort: 207 patients). Semiautomated software assessed tICH expansion (defined as ≥33% or 5 mL absolute growth). MLR was acquired from routine blood tests upon admission. We constructed two predictive models: basic combined model of clinical and imaging variables and MLR combined model of both MLR and other variables in the basic model. Receiver operating characteristic (ROC) analysis and decision curve analysis (DCA) were used to estimate the performance of MLR for predicting acute tICH expansion. Results. MLR was significantly larger in patients with acute tICH expansion compared to those without acute tICH expansion (mean [SD], 1.08 [1.05] vs. 0.59 [0.37], P<0.001). A nonlinear positive relationship between MLR and the incidence of acute tICH expansion was observed. Multivariate logistic regression indicated MLR as an independent risk factor for acute tICH expansion (odds ratio (OR), 5.88; 95% confidence interval (CI), 4.02-8.61). The power of the multivariate model for predicting acute tICH expansion was substantially improved with the inclusion of MLR (AUC 0.86 vs. AUC 0.74, P<0.001), as was also observed in an external validation cohort (AUC 0.83 vs. AUC 0.71, P<0.001). The net benefit of MLR model was higher between threshold probabilities of 20-100% in DCA. For clinical application, a nomogram derived from the multivariate model with MLR was introduced. In addition, MLR was positively associated with 6-month unfavorable outcome. Conclusion. MLR is a novel predictor for traumatic parenchymatous hematoma expansion. A nomogram derived from the MLR model may provide an easy-to-use tool for predicting acute tICH expansion and promoting the individualized treatment of patients with hemorrhagic cerebral contusion. MLR is associated with long-term outcome after cerebral contusion. |
| format | Article |
| id | doaj-art-ea215fb742794d8da2ef7cd45e23861e |
| institution | Kabale University |
| issn | 0962-9351 1466-1861 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Mediators of Inflammation |
| spelling | doaj-art-ea215fb742794d8da2ef7cd45e23861e2025-02-03T05:57:51ZengWileyMediators of Inflammation0962-93511466-18612020-01-01202010.1155/2020/54839815483981The Monocyte-to-Lymphocyte Ratio at Hospital Admission Is a Novel Predictor for Acute Traumatic Intraparenchymal Hemorrhage Expansion after Cerebral ContusionJiangtao Sheng0Tian Li1Dongzhou Zhuang2Shirong Cai3Jinhua Yang4Faxiu Ding5Xiaoxuan Chen6Fei Tian7Mindong Huang8Lianjie Li9Kangsheng Li10Weiqiang Chen11Department of Microbiology and Immunology & Key Immunopathology Laboratory of Guangdong Province, Shantou University Medical College, Shantou, Guangdong, ChinaDepartment of Microbiology and Immunology & Key Immunopathology Laboratory of Guangdong Province, Shantou University Medical College, Shantou, Guangdong, ChinaDepartment of Neurosurgery, First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, ChinaDepartment of Neurosurgery, First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, ChinaDepartment of Neurosurgery, First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, ChinaDepartment of Neurosurgery, First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, ChinaDepartment of Microbiology and Immunology & Key Immunopathology Laboratory of Guangdong Province, Shantou University Medical College, Shantou, Guangdong, ChinaDepartment of Neurosurgery, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, ChinaDepartment of Neurosurgery, Affiliated Jieyang Hospital of Sun Yat-sen University, Jieyang, Guangdong, ChinaDepartment of Neurosurgery, Fuzhou General Hospital of Xiamen University Medical College, Fuzhou, Fujian, ChinaDepartment of Microbiology and Immunology & Key Immunopathology Laboratory of Guangdong Province, Shantou University Medical College, Shantou, Guangdong, ChinaDepartment of Neurosurgery, First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, ChinaPurpose. To explore the potential of monocyte-to-lymphocyte ratio (MLR) at hospital admission for predicting acute traumatic intraparenchymal hematoma (tICH) expansion in patients with cerebral contusion. Patients and Methods. This multicenter, observational study included patients with available at-hospital admission (baseline) and follow-up computed tomography for volumetric analysis (retrospective development cohort: 1146 patients; prospective validation cohort: 207 patients). Semiautomated software assessed tICH expansion (defined as ≥33% or 5 mL absolute growth). MLR was acquired from routine blood tests upon admission. We constructed two predictive models: basic combined model of clinical and imaging variables and MLR combined model of both MLR and other variables in the basic model. Receiver operating characteristic (ROC) analysis and decision curve analysis (DCA) were used to estimate the performance of MLR for predicting acute tICH expansion. Results. MLR was significantly larger in patients with acute tICH expansion compared to those without acute tICH expansion (mean [SD], 1.08 [1.05] vs. 0.59 [0.37], P<0.001). A nonlinear positive relationship between MLR and the incidence of acute tICH expansion was observed. Multivariate logistic regression indicated MLR as an independent risk factor for acute tICH expansion (odds ratio (OR), 5.88; 95% confidence interval (CI), 4.02-8.61). The power of the multivariate model for predicting acute tICH expansion was substantially improved with the inclusion of MLR (AUC 0.86 vs. AUC 0.74, P<0.001), as was also observed in an external validation cohort (AUC 0.83 vs. AUC 0.71, P<0.001). The net benefit of MLR model was higher between threshold probabilities of 20-100% in DCA. For clinical application, a nomogram derived from the multivariate model with MLR was introduced. In addition, MLR was positively associated with 6-month unfavorable outcome. Conclusion. MLR is a novel predictor for traumatic parenchymatous hematoma expansion. A nomogram derived from the MLR model may provide an easy-to-use tool for predicting acute tICH expansion and promoting the individualized treatment of patients with hemorrhagic cerebral contusion. MLR is associated with long-term outcome after cerebral contusion.http://dx.doi.org/10.1155/2020/5483981 |
| spellingShingle | Jiangtao Sheng Tian Li Dongzhou Zhuang Shirong Cai Jinhua Yang Faxiu Ding Xiaoxuan Chen Fei Tian Mindong Huang Lianjie Li Kangsheng Li Weiqiang Chen The Monocyte-to-Lymphocyte Ratio at Hospital Admission Is a Novel Predictor for Acute Traumatic Intraparenchymal Hemorrhage Expansion after Cerebral Contusion Mediators of Inflammation |
| title | The Monocyte-to-Lymphocyte Ratio at Hospital Admission Is a Novel Predictor for Acute Traumatic Intraparenchymal Hemorrhage Expansion after Cerebral Contusion |
| title_full | The Monocyte-to-Lymphocyte Ratio at Hospital Admission Is a Novel Predictor for Acute Traumatic Intraparenchymal Hemorrhage Expansion after Cerebral Contusion |
| title_fullStr | The Monocyte-to-Lymphocyte Ratio at Hospital Admission Is a Novel Predictor for Acute Traumatic Intraparenchymal Hemorrhage Expansion after Cerebral Contusion |
| title_full_unstemmed | The Monocyte-to-Lymphocyte Ratio at Hospital Admission Is a Novel Predictor for Acute Traumatic Intraparenchymal Hemorrhage Expansion after Cerebral Contusion |
| title_short | The Monocyte-to-Lymphocyte Ratio at Hospital Admission Is a Novel Predictor for Acute Traumatic Intraparenchymal Hemorrhage Expansion after Cerebral Contusion |
| title_sort | monocyte to lymphocyte ratio at hospital admission is a novel predictor for acute traumatic intraparenchymal hemorrhage expansion after cerebral contusion |
| url | http://dx.doi.org/10.1155/2020/5483981 |
| work_keys_str_mv | AT jiangtaosheng themonocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion AT tianli themonocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion AT dongzhouzhuang themonocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion AT shirongcai themonocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion AT jinhuayang themonocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion AT faxiuding themonocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion AT xiaoxuanchen themonocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion AT feitian themonocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion AT mindonghuang themonocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion AT lianjieli themonocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion AT kangshengli themonocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion AT weiqiangchen themonocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion AT jiangtaosheng monocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion AT tianli monocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion AT dongzhouzhuang monocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion AT shirongcai monocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion AT jinhuayang monocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion AT faxiuding monocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion AT xiaoxuanchen monocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion AT feitian monocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion AT mindonghuang monocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion AT lianjieli monocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion AT kangshengli monocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion AT weiqiangchen monocytetolymphocyteratioathospitaladmissionisanovelpredictorforacutetraumaticintraparenchymalhemorrhageexpansionaftercerebralcontusion |