Subarachnoid hemorrhage (SAH) is an uncommon subtype of stroke that represents a threat to affected patients due to functional subsequent deficits. It is known that multiple inflammatory biomarkers can be altered in this scenario but prognostication of such complications remains unpredictable. We performed a systematic review and meta-analysis to evaluate the prognostic capacity of inflammatory biomarkers in the context SAH. Databases were systematically searched for studies including inflammatory markers in the context of SAH. The main outcomes included delayed cerebral ischemia (DCI) or vasospasm, poor functional outcome, measured by Modified Rankin Scale (mRs) or Glasgow Outcome Scale (GOS), mortality and infection. We included 10532 patients, of whom 2295 were evaluated for c reactive protein (CRP), 2127 were evacuated for d-dimer, 235 were evaluated for procalcitonin, 4832 were evaluated for neutrophil-to-lymphocyte ratio (NLR) and 1552 were evaluated for platelet-to-lymphocyte ratio (PLR). Higher levels of NLR, d-dimer, and PLR were associated with a significant increase of poor outcome by mRs (OR 1.30; 95% CI 1.15- 1.47; p>0.0001); (OR 2.15; 95% CI 1.40–3.30; p=0.0005); (OR 1.03; 95% CI 1.00–1.05; p=0.03) respectively. Higher values of PLR and NLR were associated with DCI (OR 2.23; 95% CI 1.66–3.00; p<0.00001); (OR 1.62; 95% CI 1.17–2.26; p =0.004), respectively. An increased value of Procalcitonin was correlated with higher infection rates (OR 19.18; 95% CI 8.17–45.00;p<0.00001).Elevated NLR, d-dimer and PLR were associated with poor functional outcome. Higher PLR and NLR were also shown to increase risk of DCI. Meanwhile, increased procalcitonin values correlate to higher infection rates.

Disclosures B. Lucke-Wold: None. J. Pontes: None. G. Nager: None.