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Título

Complete Blood Count in Aneurysmal Subarachnoid Hemorrhage Scenario: Possible Uses of Blood Elements for Predicting Outcomes

RESUMO

Introduction: Aneurysmal subarachnoid hemorrhage (SAH) is a worldwide health burden with high fatality and permanent disability rates, and variable prognosis. Recent evidence suggests that some biomarkers play a critical role in predicting outcomes.

Objectives: We propose a systematic review of literature on recent advances in blood element biomarkers for aneurysmal SAH, translating from a physiological point of view to their potential usefulness.

Methodology: Pubmed, Embase, Scopus, Cochrane, and Web of Science databases were systematically searched to identify studies assessing red blood cell element biomarkers for aneurysmal subarachnoid hemorrhage, following sensibility, and specificity results found in each paper published.

Results: Six studies were included. Delayed Cerebral Ischemia (DCI) was predicted by Neutrophil/Lymphocyte ratio (87.3%/48.4%, and 63%/53%), and Platelet/Lymphocyte ratio (55.3%/78.5%). Vasospasm was seen by Platelets (40%/90.5%, and 78%/85%), Lymphocytes (57.9%/83.3%), Neutrophils (40%/100%), Leukocytes (50%/100%), and Combined Platelet and Leukocytes high values (60%/89.5%). Rebleeding in Neutrophil/Lymphocyte ratio (72.3%/63.3%), and Neutrophil/Lymphocyte ratio combined with Fisher Grade (39.94%/100%). Poor outcome in Neutrophil/Lymphocyte ratio (74.5%/69.3%), and Platelet/Lymphocyte ratio (55.3%/78.5%). Mortality in 3-months appears predicted by RDW value (80.6%/91.6%).

Conclusion: Biomarkers could help in predicting complications in aneurysmal subarachnoid hemorrhage patients. We listed some of the recent advances in this translational, intriguing, fast-growing field. Although the knowledge gaps are still significant, some markers are demonstrating promising results and could be helping patients in the near future.