Clinical value of serum NSE and PLR in predicting short-term cognitive dysfunction after endovascular treatment of aneurysmal subarachnoid hemorrhage

LIANG Shuang; LI Xiaopeng; WU Hao; TUERHONG.TUERXUN; MA Long

doi:10.3639/j.issn.1671-2897.2025.04.016

Abstract：Objective To explore the clinical value of serum neuron-specific enolase(NSE)and platelet-to-lymphocyte ratio(PLR)in predicting short-term cognitive dysfunction after endovascular treatment of aneurysmal subarachnoid hemorrhage(aSAH).Methods A total of 152 patients with aSAH admitted to our hospital from October 2021 to September 2024 were selected as the research subjects.Three months after endovascular treatment,the cognitive function of the patients was evaluated using the Montreal Cognitive Assessment Scale(MoCA),and they were then divided into the normal cognitive function group(MoCA score≥26,n=98)and the cognitive dysfunction group(MoCA score<26,n=54).The predictive value of serum NSE and PLR for short-term cognitive dysfunction after endovascular treatment of aSAH was evaluated by ROC.The influencing factors of short-term cognitive dysfunction after endovascular treatment of aSAH were explored by Multivariate Logistic regression.Results The levels of serum NSE and PLR in the cognitive dysfunction group were higher than those in the normal cognitive function group(P<0.05).The area under the curve of serum NSE,PLR,and their combination for predicting short-term cognitive dysfunction after endovascular treatment of aSAH were 0.869(95%CI:0.817-0.921),0.753(95%CI:0.701-0.805),and 0.906(95%CI:0.854-0.958)respectively.The age,proportion of hypertension history,Hunt Hess grading(Ⅲ-Ⅳ),and proportion of ventricular drainage in the cognitive impairment group were all higher than those in the normal cognitive function group.At admission,the Glasgow Coma Scale(GCS)score was lower than that in the normal cognitive function group,and the time from surgery to onset was longer than that in the normal cognitive function group(P<0.05).Multivariate analysis showed that a history of hypertension(OR=2.065,95%CI:1.457-2.927),Low GCS score upon admission(OR=0.430,95%CI:0.292-0.632),high Hunt-Hess grade(OR=2.812,95%CI:1.834-4.311),elevated NSE level(OR=3.117,95%CI:2.010-4.836),and high PLR(OR=2.497,95%CI:1.677-3.717)were independent risk factors for short-term cognitive dysfunction after endovascular treatment of aSAH(P<0.05).Conclusion Elevated serum NSE level and high PLR are associated with short-term cognitive dysfunction after endovascular treatment of aSAH and can be used as important predictive factors for short-term cognitive dysfunction after endovascular treatment.