Systemic response of coated-platelet and peripheral blood inflammatory cell indices after aneurysmal subarachnoid hemorrhage and long-term clinical outcome

Bappaditya Ray, Stephen R. Ross, Gopichand Danala, Faranak Aghaei, Claire Delpirou Nouh, Lance Ford, Kimberly M. Hollabaugh, Brittany N. Karfonta, Joshua A. Santucci, Benjamin O. Cornwell, Bradley N. Bohnstedt, Bin Zheng, George L. Dale, Calin I. Prodan

Research output: Contribution to journalArticle

Abstract

Purpose: Post-hemorrhage period after aneurysmal subarachnoid hemorrhage (aSAH) has several systemic manifestations including prothrombotic and pro-inflammatory states. Inter-relationship between these states using established/routine laboratory biomarkers and its long-term effect on clinical outcome is not well-defined. Materials and methods: Retrospective analysis of prospective cohort of 44 aSAH patients. Trend of procoagulant biomarkers [coated-platelets, mean platelet volume to platelet count (MPV:PLT)] and peripheral inflammatory biomarkers [platelet-lymphocyte ratio (PLR), neutrophil-platelet ratio (NLR)] were analyzed using regression analysis. Occurrence of delayed cerebral ischemia (DCI), modified Rankin score (mRS) of 3–6 and Montreal cognitive assessment (MoCA) of <26 at 1-year defined adverse clinical outcome. Results: Patients with worse mRS and MoCA score had higher rise in coated-platelet compared to those with better scores [20.4 (IQR: 15.6, 32.9) vs. 10.95 (IQR: 6.1, 18.9), p = 0.003] and [16.9 (IQR: 13.4, 28.1) vs. 10.95 (IQR: 6.35, 18.65), p = 0.02] respectively. NLR and PLR trends showed significant initial decline followed by a gradual rise in NLR among those without DCI as compared to persistent low levels in those developing DCI (0.13 units/day vs. -0.07 units/day, p = 0.06). Conclusions: Coated-platelet rise after aSAH is associated with adverse long-term clinical outcome. NLR and PLR trends show an early immune-depressed state after aSAH.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalJournal of Critical Care
Volume52
DOIs
StatePublished - Aug 2019
Externally publishedYes

Fingerprint

Subarachnoid Hemorrhage
Blood Cells
Blood Platelets
Neutrophils
Brain Ischemia
Biomarkers
Lymphocytes
Mean Platelet Volume
Platelet Count
Cohort Studies
Regression Analysis
Hemorrhage

Keywords

  • Hemorrhagic stroke
  • Long-term stroke morbidity
  • Neutrophil-lymphocyte ratio
  • Platelet-lymphocyte ratio
  • Reactive platelets

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Systemic response of coated-platelet and peripheral blood inflammatory cell indices after aneurysmal subarachnoid hemorrhage and long-term clinical outcome. / Ray, Bappaditya; Ross, Stephen R.; Danala, Gopichand; Aghaei, Faranak; Nouh, Claire Delpirou; Ford, Lance; Hollabaugh, Kimberly M.; Karfonta, Brittany N.; Santucci, Joshua A.; Cornwell, Benjamin O.; Bohnstedt, Bradley N.; Zheng, Bin; Dale, George L.; Prodan, Calin I.

In: Journal of Critical Care, Vol. 52, 08.2019, p. 1-9.

Research output: Contribution to journalArticle

Ray, B, Ross, SR, Danala, G, Aghaei, F, Nouh, CD, Ford, L, Hollabaugh, KM, Karfonta, BN, Santucci, JA, Cornwell, BO, Bohnstedt, BN, Zheng, B, Dale, GL & Prodan, CI 2019, 'Systemic response of coated-platelet and peripheral blood inflammatory cell indices after aneurysmal subarachnoid hemorrhage and long-term clinical outcome', Journal of Critical Care, vol. 52, pp. 1-9. https://doi.org/10.1016/j.jcrc.2019.03.003
Ray, Bappaditya ; Ross, Stephen R. ; Danala, Gopichand ; Aghaei, Faranak ; Nouh, Claire Delpirou ; Ford, Lance ; Hollabaugh, Kimberly M. ; Karfonta, Brittany N. ; Santucci, Joshua A. ; Cornwell, Benjamin O. ; Bohnstedt, Bradley N. ; Zheng, Bin ; Dale, George L. ; Prodan, Calin I. / Systemic response of coated-platelet and peripheral blood inflammatory cell indices after aneurysmal subarachnoid hemorrhage and long-term clinical outcome. In: Journal of Critical Care. 2019 ; Vol. 52. pp. 1-9.
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abstract = "Purpose: Post-hemorrhage period after aneurysmal subarachnoid hemorrhage (aSAH) has several systemic manifestations including prothrombotic and pro-inflammatory states. Inter-relationship between these states using established/routine laboratory biomarkers and its long-term effect on clinical outcome is not well-defined. Materials and methods: Retrospective analysis of prospective cohort of 44 aSAH patients. Trend of procoagulant biomarkers [coated-platelets, mean platelet volume to platelet count (MPV:PLT)] and peripheral inflammatory biomarkers [platelet-lymphocyte ratio (PLR), neutrophil-platelet ratio (NLR)] were analyzed using regression analysis. Occurrence of delayed cerebral ischemia (DCI), modified Rankin score (mRS) of 3–6 and Montreal cognitive assessment (MoCA) of <26 at 1-year defined adverse clinical outcome. Results: Patients with worse mRS and MoCA score had higher rise in coated-platelet compared to those with better scores [20.4 (IQR: 15.6, 32.9) vs. 10.95 (IQR: 6.1, 18.9), p = 0.003] and [16.9 (IQR: 13.4, 28.1) vs. 10.95 (IQR: 6.35, 18.65), p = 0.02] respectively. NLR and PLR trends showed significant initial decline followed by a gradual rise in NLR among those without DCI as compared to persistent low levels in those developing DCI (0.13 units/day vs. -0.07 units/day, p = 0.06). Conclusions: Coated-platelet rise after aSAH is associated with adverse long-term clinical outcome. NLR and PLR trends show an early immune-depressed state after aSAH.",
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author = "Bappaditya Ray and Ross, {Stephen R.} and Gopichand Danala and Faranak Aghaei and Nouh, {Claire Delpirou} and Lance Ford and Hollabaugh, {Kimberly M.} and Karfonta, {Brittany N.} and Santucci, {Joshua A.} and Cornwell, {Benjamin O.} and Bohnstedt, {Bradley N.} and Bin Zheng and Dale, {George L.} and Prodan, {Calin I.}",
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T1 - Systemic response of coated-platelet and peripheral blood inflammatory cell indices after aneurysmal subarachnoid hemorrhage and long-term clinical outcome

AU - Ray, Bappaditya

AU - Ross, Stephen R.

AU - Danala, Gopichand

AU - Aghaei, Faranak

AU - Nouh, Claire Delpirou

AU - Ford, Lance

AU - Hollabaugh, Kimberly M.

AU - Karfonta, Brittany N.

AU - Santucci, Joshua A.

AU - Cornwell, Benjamin O.

AU - Bohnstedt, Bradley N.

AU - Zheng, Bin

AU - Dale, George L.

AU - Prodan, Calin I.

PY - 2019/8

Y1 - 2019/8

N2 - Purpose: Post-hemorrhage period after aneurysmal subarachnoid hemorrhage (aSAH) has several systemic manifestations including prothrombotic and pro-inflammatory states. Inter-relationship between these states using established/routine laboratory biomarkers and its long-term effect on clinical outcome is not well-defined. Materials and methods: Retrospective analysis of prospective cohort of 44 aSAH patients. Trend of procoagulant biomarkers [coated-platelets, mean platelet volume to platelet count (MPV:PLT)] and peripheral inflammatory biomarkers [platelet-lymphocyte ratio (PLR), neutrophil-platelet ratio (NLR)] were analyzed using regression analysis. Occurrence of delayed cerebral ischemia (DCI), modified Rankin score (mRS) of 3–6 and Montreal cognitive assessment (MoCA) of <26 at 1-year defined adverse clinical outcome. Results: Patients with worse mRS and MoCA score had higher rise in coated-platelet compared to those with better scores [20.4 (IQR: 15.6, 32.9) vs. 10.95 (IQR: 6.1, 18.9), p = 0.003] and [16.9 (IQR: 13.4, 28.1) vs. 10.95 (IQR: 6.35, 18.65), p = 0.02] respectively. NLR and PLR trends showed significant initial decline followed by a gradual rise in NLR among those without DCI as compared to persistent low levels in those developing DCI (0.13 units/day vs. -0.07 units/day, p = 0.06). Conclusions: Coated-platelet rise after aSAH is associated with adverse long-term clinical outcome. NLR and PLR trends show an early immune-depressed state after aSAH.

AB - Purpose: Post-hemorrhage period after aneurysmal subarachnoid hemorrhage (aSAH) has several systemic manifestations including prothrombotic and pro-inflammatory states. Inter-relationship between these states using established/routine laboratory biomarkers and its long-term effect on clinical outcome is not well-defined. Materials and methods: Retrospective analysis of prospective cohort of 44 aSAH patients. Trend of procoagulant biomarkers [coated-platelets, mean platelet volume to platelet count (MPV:PLT)] and peripheral inflammatory biomarkers [platelet-lymphocyte ratio (PLR), neutrophil-platelet ratio (NLR)] were analyzed using regression analysis. Occurrence of delayed cerebral ischemia (DCI), modified Rankin score (mRS) of 3–6 and Montreal cognitive assessment (MoCA) of <26 at 1-year defined adverse clinical outcome. Results: Patients with worse mRS and MoCA score had higher rise in coated-platelet compared to those with better scores [20.4 (IQR: 15.6, 32.9) vs. 10.95 (IQR: 6.1, 18.9), p = 0.003] and [16.9 (IQR: 13.4, 28.1) vs. 10.95 (IQR: 6.35, 18.65), p = 0.02] respectively. NLR and PLR trends showed significant initial decline followed by a gradual rise in NLR among those without DCI as compared to persistent low levels in those developing DCI (0.13 units/day vs. -0.07 units/day, p = 0.06). Conclusions: Coated-platelet rise after aSAH is associated with adverse long-term clinical outcome. NLR and PLR trends show an early immune-depressed state after aSAH.

KW - Hemorrhagic stroke

KW - Long-term stroke morbidity

KW - Neutrophil-lymphocyte ratio

KW - Platelet-lymphocyte ratio

KW - Reactive platelets

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