Objective: Prognostic significance of inflammatory response has been reported in various
diseases. The objective of this study was to analyze the association between inflammation-
based scores and the prognosis of patients who underwent neuro-intervention for aneurysmal
subarachnoid hemorrhage (SAH).
Methods: Inflammation-based scores such as neutrophil to lymphocyte ratio (NLR), lymphocyte to
monocyte ratio (LMR), and monocyte to high-density lipoprotein cholesterol (HDL-C) ratio
(MHR) were analyzed for aneurysmal SAH patients who underwent endovascular intervention. Unfavorable
functional outcome was defined as a modified Rankin Scale (mRS) score of 3-6. Receiver
operating characteristic (ROC) curve analysis was performed to identify cut-off values of inflammation-
based scores for predicting unfavorable functional outcome. Logistic regression analyses
were performed to explore the relationship between inflammation-based scores and the prognosis
Results: A total of 498 patients were enrolled. Optimal cutoff values of inflammation-based scores
of NLR, LMR, and MHR for unfavorable functional outcome were 5.7, 4.2, and 1.5, respectively
(p < 0.001, < 0.001, and 0.004, respectively). In multivariate analysis, NLR value ≥ 5.7 (odds ratio
[OR] 1.92, 95% CI 1.42–3.42; P = 0.008), LMR value < 4.2 (OR 1.74, 95% CI 1.48–2.98; P =
0.018), and MHR value ≥ 1.5 (OR 1.44, 95% CI 1.22–2.82; P = 0.040) were independently associated
with unfavorable functional outcome.
Conclusion: Inflammation based scores were associated with functional outcome after endovascular
intervention for aneurysmal SAH. Higher NLR and MHR with lower LMR could predict unfavorable
outcomes of aneurysmal SAH patients who underwent endovascular intervention.