Dynamic changes of platelets before and after surgery predict the prognosis of patients with aneurysmal subarachnoid hemorrhage
Yunfan Zhou,
Ke Wang,
Runting Li,
Fa Lin,
Yu Chen,
Jun Yang,
Heze Han,
Tu Li,
Yitong Jia,
Kexin Yuan,
Haibin Zhang,
Ruinan Li,
Zhipeng Li,
Cunyang Li,
Yahui Zhao,
Qiang Hao,
Xiaolin Chen,
Yuanli Zhao
Affiliations
Yunfan Zhou
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
Ke Wang
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
Runting Li
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
Fa Lin
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
Yu Chen
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
Jun Yang
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
Heze Han
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
Tu Li
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
Yitong Jia
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
Kexin Yuan
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
Haibin Zhang
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
Ruinan Li
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
Zhipeng Li
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
Cunyang Li
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
Yahui Zhao
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
Qiang Hao
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Stroke Center, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
Xiaolin Chen
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Stroke Center, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China; Corresponding author. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China.
Yuanli Zhao
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Stroke Center, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China; Corresponding author. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China.
Objective: This investigation explored the association between postoperative/preoperative platelet ratio (PPR) and the incidence of unfavorable outcomes within 90 days in individuals with aneurysmal subarachnoid hemorrhage (aSAH). Methods: This investigation, utilizing data from 2015 to 2022, concentrated on patients diagnosed with aSAH, categorizing them into four groups based on PPR quartiles. The association between PPR levels and clinical outcomes—comprising in-hospital complications, mortality, and modified Rankin Scale (mRS) scores at discharge and 90 days after that—was evaluated through logistic regression analyses. To explore potential non-linear associations between PPR levels and outcomes, restricted cubic spline (RCS) regression was applied. Further, mediation analysis was performed to elucidate the role of in-hospital complications in modulating the impact of PPR levels on 90-day outcomes. Results: This study analyzed data from 948 patients. Upon adjustment for confounding variables, it was observed that patients in the higher quartiles showed reduced incidences of anemia, hypoproteinemia, and pneumonia, alongside a decreased frequency of unfavorable outcomes within a 90-day follow-up period. The RCS analysis indicated a linear association of PPR with pneumonia, hypoproteinemia, and adverse 90-day outcomes (p for nonlinear = 0.61, 0.52, and 0.96, respectively). Moreover, the association of PPR with anemia was found to be nonlinear (p for nonlinear = 0.01). Mediation analysis further indicated that anemia and pneumonia significantly influenced the association between PPR and unfavorable outcomes at 90 days, accounting for 15.49 % and 27.61 % of the effect, respectively. Conclusions: This study establishes a significant correlation between decreased PPR levels and 90-day adverse outcomes following aSAH, potentially relating to pneumonia and anemia.
