# Study on the non-linear relationship between neutrophil-to-lymphocyte ratio and prognosis of spontaneous intraventricular hemorrhage

**Authors:** Jun-Jian Zhou, Ming Lu, Wen-Bin Dai

PMC · DOI: 10.3389/fneur.2025.1768967 · Frontiers in Neurology · 2026-01-15

## TL;DR

This study finds a J-shaped relationship between neutrophil-to-lymphocyte ratio (NLR) and poor outcomes in patients with spontaneous intraventricular hemorrhage.

## Contribution

The study reveals a non-linear, J-shaped association between NLR and prognosis in spontaneous intraventricular hemorrhage patients.

## Key findings

- A J-shaped relationship was observed, with increased NLR up to 8.26 linked to higher risk of poor outcomes.
- NLR was identified as an independent predictor of 90-day prognosis in spontaneous intraventricular hemorrhage patients.
- The odds ratio for poor outcomes was significant for NLR below 8.26 but not for values above this threshold.

## Abstract

The neutrophil-to-lymphocyte ratio (NLR), as an inflammatory marker, has been shown to be associated with the prognosis of various cerebrovascular diseases. However, the specific non-linear relationship between NLR and the prognosis of spontaneous intraventricular hemorrhage (sIVH) remains unclear. This study aimed to investigate the non-linear association between NLR and poor outcomes in sIVH patients.

This retrospective study analyzed data from Xiaoshan First People’s Hospital, including all patients hospitalized for sIVH. Blood samples were collected immediately upon hospital admission to calculate NLR, and its relationship with 90-day functional outcomes (defined as poor prognosis with a modified Rankin Scale score ≥4) was evaluated.

The analysis revealed a J-shaped relationship between NLR and poor outcomes in sIVH patients. As NLR levels increased, the risk of poor outcomes rose, reaching saturation at approximately 8.26. Specifically, when NLR was below 8.26, the odds ratio was 1.49 (95% CI: 1.16–1.91, p = 0.0018); when NLR was above 8.26, the odds ratio was 0.95 (95% CI: 0.84–1.07, p = 0.4194). Multivariate analysis indicated that NLR was an independent predictor of 90-day prognosis in sIVH patients.

NLR can serve as an important indicator for assessing the prognosis of sIVH patients. The non-linear relationship between NLR and poor outcomes provides new insights for clinical management. Further studies should explore the mechanisms of NLR and its potential applications in sIVH treatment.

## Full-text entities

- **Diseases:** inflammatory (MESH:D007249), cerebrovascular diseases (MESH:D002561), intraventricular hemorrhage (MESH:D000074042)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

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## References

48 references — full list in the complete paper: https://tomesphere.com/paper/PMC12857059/full.md

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Source: https://tomesphere.com/paper/PMC12857059