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

3 Scopus citations

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

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

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    Ray, B., Ross, S. R., Danala, G., Aghaei, F., Nouh, C. D., Ford, L., Hollabaugh, K. M., Karfonta, B. N., Santucci, J. A., Cornwell, B. O., Bohnstedt, B. N., Zheng, B., Dale, G. L., & Prodan, C. I. (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, 52, 1-9. https://doi.org/10.1016/j.jcrc.2019.03.003