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Journals / Batı Karadeniz Tıp Dergisi / 2026 / Cilt: 10 Sayı: 2

Inflammation–nutritional profile and functional outcomes in aneurysmal subarachnoid hemorrhage: A single-center retrospective cohort study

Anevrizmal subaraknoid kanamada inflamasyon–nutrisyon profili ve fonksiyonel sonuçlar: Tek merkezli retrospektif kohort çalışması

Ayşegül Esen Aydın(Prof. Dr. Cemil Taşcıoğlu Şehir Hastanesi, Beyin ve Sinir Cerrahisi Kliniği, İstanbul, Türkiye)0000-0001-7444-8156
Ercan İvgen(Prof. Dr. Cemil Taşcıoğlu Şehir Hastanesi, Beyin ve Sinir Cerrahisi Kliniği, İstanbul, Türkiye)0009-0003-8732-3805
Eren Soğuk(Prof. Dr. Cemil Taşcıoğlu Şehir Hastanesi, Beyin ve Sinir Cerrahisi Kliniği, İstanbul, Türkiye)0000-0003-3388-1230
Şeyma Tangut(Prof. Dr. Cemil Taşcıoğlu Şehir Hastanesi, Beyin ve Sinir Cerrahisi Kliniği, İstanbul, Türkiye)0009-0005-3630-4430
Seçkin Aydın(Prof. Dr. Cemil Taşcıoğlu Şehir Hastanesi, Beyin ve Sinir Cerrahisi Kliniği, İstanbul, Türkiye)0000-0003-1195-9084
Ahmet Murat Müslüman(Prof. Dr. Cemil Taşcıoğlu Şehir Hastanesi, Beyin ve Sinir Cerrahisi Kliniği, İstanbul, Türkiye)0000-0002-8009-9842
Pages
311–320
Publication Date
2026-08-31
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Combined evaluation of inflammatory response and nutritional reserve may provide practical clinical value for early prognostic assessment in patients with aSAH.

📌 3 Key Takeaways

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Objective & Hypothesis:Aim: Aneurysmal subarachnoid hemorrhage (aSAH) remains a major neurovascular emergency associated with high mortality and neurological morbidity.
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Key Findings & Data:Material and Methods: A total of 73 patients who underwent microsurgical clipping for aSAH between January 2021 and December 2025 were retrospectively evaluated.
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Conclusion & Impact:Combined evaluation of inflammatory response and nutritional reserve may provide practical clinical value for early prognostic assessment in patients with aSAH.
🔬Design:Araştırma Makalesi
📍Scope:2021 Verileri
⚙️Variables:Anevrizmal subaraknoid kanama · serebral anevrizma · inflamasyon

Abstract

Aim: Aneurysmal subarachnoid hemorrhage (aSAH) remains a major neurovascular emergency associated with high mortality and neurological morbidity. Increasing evidence suggests that systemic inflammatory response and nutritional reserve may influence clinical outcomes after aSAH. The present study aimed to evaluate the relationship between early inflammatory and nutritional biomarkers and clinical outcomes in patients treated with microsurgical clipping for aSAH. Material and Methods: A total of 73 patients who underwent microsurgical clipping for aSAH between January 2021 and December 2025 were retrospectively evaluated. Demographic characteristics, clinical and radiological grading scales, intensive care parameters, and laboratory findings were analyzed. Neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), C-reactive protein-to-albumin ratio (CAR), and prognostic nutritional index (PNI) were calculated using laboratory data obtained within the first 24 hours after admission. Functional outcomes were assessed using the modified Rankin Scale (mRS). Results: The mean age of the patients was 56.1±12.8 years, and 64.4% were female. CAR was significantly higher in the poor outcome group (p=0.010), whereas NLR showed a borderline increase (p=0.050). SII and SIRI values were higher in the poor outcome group but did not reach statistical significance (p=0.096 and p=0.081, respectively). Multivariate analysis demonstrated that older age, higher World Federation of Neurosurgical Societies (WFNS) score, and elevated CAR level were independent predictors of poor functional outcome. Receiver operating characteristic (ROC) analysis revealed that CAR had one of the highest discriminative performances for predicting poor clinical outcome. Conclusion: Early inflammatory and nutritional biomarkers appear to be associated with clinical prognosis in patients with aSAH treated by microsurgical clipping. Elevated CAR emerged as an independent predictor of poor functional outcome, whereas NLR showed a borderline association with poor outcome. Combined evaluation of inflammatory response and nutritional reserve may provide practical clinical value for early prognostic assessment in patients with aSAH.

Özet

Amaç: Anevrizmal subaraknoid kanama (aSAK), yüksek mortalite ve morbidite ile ilişkili önemli bir nörovasküler acildir. Son yıllarda sistemik inflamatuvar yanıtın ve nutrisyonel rezervin klinik prognoz üzerindeki etkisi giderek daha fazla dikkat çekmektedir. Bu çalışmada, mikrocerrahi klipleme uygulanan aSAK hastalarında erken dönem inflamatuvar ve nutrisyonel biyobelirteçlerin klinik sonuçlarla ilişkisinin değerlendirilmesi amaçlandı. Gereç ve Yöntemler: Ocak 2021–Aralık 2025 tarihleri arasında aSAK nedeniyle mikrocerrahi klipleme uygulanan 73 hasta retrospektif olarak değerlendirildi. Hastaların demografik özellikleri, klinik ve radyolojik derecelendirme sistemleri, yoğun bakım süreçleri ve laboratuvar verileri analiz edildi. Başvuru sonrası ilk 24 saat içerisinde elde edilen laboratuvar parametreleri kullanılarak nötrofil-lenfosit oranı (NLR), sistemik immün-inflamasyon indeksi (SII), sistemik inflamasyon yanıt indeksi (SIRI), C-reaktif protein/albümin oranı (CAR) ve prognostik nutrisyonel indeks (PNI) hesaplandı. Fonksiyonel sonuçlar modified Rankin Scale (mRS) skoruna göre değerlendirildi. Bulgular: Hastaların yaş ortalaması 56.1±12.8 yıl olup olguların %64.4’ü kadındı. Kötü fonksiyonel sonuç grubunda CAR değeri anlamlı olarak daha yüksek bulundu (p=0.010); NLR değeri ise sınırda anlamlılık düzeyinde yüksek izlendi (p=0.050). SII ve SIRI değerleri kötü sonuç grubunda daha yüksek olmakla birlikte istatistiksel anlamlılık düzeyine ulaşmadı (sırasıyla p=0.096 ve p=0.081). PNI değerleri kötü sonuç grubunda daha düşük saptandı ancak anlamlı farklılık izlenmedi. Çok değişkenli analizde ileri yaş, yüksek World Federation of Neurosurgical Societies (WFNS) skoru ve yüksek CAR düzeyi kötü fonksiyonel sonuç açısından bağımsız prediktörler olarak bulundu. Receiver operating characteristic (ROC) analizinde CAR’nin kötü klinik sonlanımı öngörmede en yüksek ayırt edici performansa sahip biyobelirteçlerden biri olduğu görüldü. Sonuç: Mikrocerrahi klipleme uygulanan aSAK hastalarında erken dönem inflamatuvar ve nutrisyonel biyobelirteçler klinik prognoz ile ilişkili görünmektedir. Özellikle yüksek NLR ve CAR değerleri kötü fonksiyonel sonuç ile ilişkili bulunmuştur. İnflamasyon ve nutrisyonel rezervin birlikte değerlendirilmesi, aSAK hastalarında erken dönem prognostik değerlendirme açısından klinik katkı sağlayabilir.

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Cite This Article

Aydın, A. E., İvgen, E., Soğuk, E., Tangut, Ş., Aydın, S., Müslüman, A. M. (2026). Inflammation–nutritional profile and functional outcomes in aneurysmal subarachnoid hemorrhage: A single-center retrospective cohort study. Batı Karadeniz Tıp Dergisi, Cilt: 10 Sayı: 2, 311–320. https://doi.org/10.29058/mjwbs.1963622

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References (22)

  1. İlhan Y, Eseoğlu M, Demirgil BT. Anevrizmaya bağlı spontan subaraknoid kanamalar: 328 vakalık retrospektif inceleme. Fırat Tıp Derg. 2012;17(3):156-160.
  2. Pehlivanlar Küçük M, Öztürk ÇE, Küçük AO, Turunç E, Ülger F. Short-term results of patients with spontaneous subarachnoid hemorrhage in intensive care unit: single-center experience. Turk J Intensive Care. 2021;19(4):174-183. https://doi.org/10.4274/tybd.galenos.2021.64936
  3. Cetinkaya O, Arslan U, Temel H, Kavakli AS, Cakin H, Cengiz M, et al. Factors Influencing the Mortality of Patients with Subarachnoid Haemorrhage in the Intensive Care Unit: A Retrospective Cohort Study. J Clin Med. 2025;14(5):1650. https://doi.org/10.3390/jcm14051650
  4. Ogden M, Bakar B, Karagedik MI, Bulut IU, Cetin C, Aydin G, et al. Analysis of biochemical laboratory values to determine etiology and prognosis in patients with subarachnoid hemorrhage: a clinical study. Neurol Res. 2019;41(2):156-167. https://doi.org/10.1080/01616412.2018.1545414
  5. Song SY, Zhao XX, Rajah G, Hua C, Kang RJ, Han YP, et al. Clinical significance of baseline neutrophil-to-lymphocyte ratio in patients with ischemic stroke or hemorrhagic stroke: an updated meta-analysis. Front Neurol. 2019;10:1032. https://doi.org/10.3389/fneur.2019.01032
  6. Cai L, Zeng H, Tan X, Wu X, Qian C, Chen G. The role of the blood neutrophil-to-lymphocyte ratio in aneurysmal subarachnoid hemorrhage. Front Neurol. 2021;12:671098. https://doi.org/10.3389/fneur.2021.671098
  7. Wang X, Tian W, Zhao Y, Yang Y, Deng L. Systemic immune inflammation index and system inflammation response index on the third postoperative day predict poor prognosis of aneurysmal subarachnoid hemorrhage patients. Medicine (Baltimore). 2024;103(16):e37818. https://doi.org/10.1097/MD.0000000000037818
  8. Sun Z, Xue F, Wang K, Zhang D, Dong M, Zhang J. A nomogram model for predicting postoperative prognosis in patients with aneurysmal subarachnoid hemorrhage using preoperative biochemical indices. BMC Neurol. 2024;24(1):270. https://doi.org/10.1186/s12883-024-03774-1
  9. Lim SW, Jo WY, Park HP. A low preoperative platelet-to-white blood cell ratio is associated with acute kidney injury following cerebral aneurysm treatment in South Korea. Acute Crit Care. 2025;40(1):59-68. https://doi.org/10.4266/acc.003120
  10. Al-Mufti F, Amuluru K, Damodara N, Dodson V, Roh D, Agarwal S, et al. Admission neutrophil-lymphocyte ratio predicts delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage. J Neurointerv Surg. 2019;11(11):1135-1140. https://doi.org/10.1136/neurintsurg-2019-014759
  11. Wu Y, He Q, Wei Y, Zhu J, He Z, Zhang X, et al. The association of neutrophil-to-lymphocyte ratio and delayed cerebral ischemia in patients with aneurysmal subarachnoid hemorrhage: possible involvement of cerebral blood perfusion. Neuropsychiatr Dis Treat. 2019;15:1001-1007. https://doi.org/10.2147/NDT.S190477
  12. Zhao J, Feng J, Ma Q, Li C, Qiu F. Prognostic value of inflammation biomarkers for 30-day mortality in critically ill patients with stroke. Front Neurol. 2023;14:1110347. https://doi.org/10.3389/fneur.2023.1110347
  13. Hernandez EF, Go CJT, Collantes MEV. Admission neutrophil-to-lymphocyte ratio as a predictive factor in the outcome of acute spontaneous intracerebral hemorrhage. Acta Med Philipp. 2024;58(15):61-66.https://doi.org/10.47895/amp.vi0.7456
  14. Jamali SA, Turnbull MT, Kanekiyo T, Vishnu P, Zubair AC, Raper CC, et al. Elevated neutrophil-lymphocyte ratio is predictive of poor outcomes following aneurysmal subarachnoid hemorrhage. J Stroke Cerebrovasc Dis. 2020;29(4):104631. https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.104631
  15. Giede-Jeppe A, Reichl J, Sprügel MI, Lücking H, Hoelter P, Eyüpoglu IY, et al. Neutrophil-to-lymphocyte ratio as an independent predictor for unfavorable functional outcome in aneurysmal subarachnoid hemorrhage. J Neurosurg. 2019;132(2):400-407. https://doi.org/10.3171/2018.9.JNS181975
  16. Varol E, Avci F, Yaltırık CK. Evaluation of c-reactive protein levels as prognostic indicators in subarachnoid hemorrhage patients. med J West Black Sea. 2025;9(2):293-298. https://doi.org/10.29058/mjwbs.1755419
  17. Luo F, Li Y, Zhao Y, Sun M, He Q, Wen R, et al. Systemic immune-inflammation index predicts the outcome after aneurysmal subarachnoid hemorrhage. Neurosurg Rev. 2022;45(2):1607-1615. https://doi.org/10.1007/s10143-021-01681-4
  18. Li J, Yuan Y, Liao X, Yu Z, Li H, Zheng J. Prognostic significance of admission systemic inflammation response index in patients with spontaneous intracerebral hemorrhage: a propensity score matching analysis. Front Neurol. 2021;12. https://doi.org/10.3389/fneur.2021.718032
  19. Gel M, Keskin E, Daltaban İS. Anevrizmatik subaraknoid kanamada ultra-erken ve erken tedavinin etkileri: tek merkezli retroprospektif çalışma. Med J West Black Sea. 2024;8(1):67-71. https://doi.org/10.29058/mjwbs.1452463
  20. Sukun A, Cetin M, Alparslan A, Uyar R, Gediz T, Cekic B, et al. Mortality outcomes of endovascular treatment and surgical clipping in patients with cerebral aneurysms: a single-center study. Turk Neurosurg. 2022;32(2):221-227. https://doi.org/10.5137/1019-5149.JTN.33877-21.2
  21. Lu W, Tong Y, Zhang C, Xiang L, Xiang L, Chen C, et al. A novel visual dynamic nomogram to online predict the risk of unfavorable outcome in elderly aSAH patients after endovascular coiling: a retrospective study. Front Neurosci. 2023;16:1037895. https://doi.org/10.3389/fnins.2022.1037895
  22. Lindgren A, Vergouwen MDI, van der Schaaf IC, Algra A, Wermer MJH, Clarke MJ, et al. Endovascular coiling versus neurosurgical clipping for people with aneurysmal subarachnoid haemorrhage. Cochrane Database Syst Rev. 2018;2018(8):CD003085. https://doi.org/10.1002/14651858.CD003085.pub3