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  4. Vol 4, Issue 1, 2026

Predictive Value of Combined NLR and CRP Detection for the Efficacy of Third-Generation Cephalosporins in Post-Intracerebral Hemorrhage Pneumonia: A Retrospective Study

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DOI: 10.23977/medbm.2026.040112 | Downloads: 6 | Views: 89

Author(s)

Jing Wang 1, Xian Wang 2, Yuan Yao 3, Xiong Yang 3, Zhansheng Zhu 3

Affiliation(s)

1 Department of Health Management Centre, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, China
2 Department of Pharmacy, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, China
3 Department of Neurosurgery, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, China

Corresponding Author

Xiong Yang

ABSTRACT

This retrospective study aimed to evaluate the predictive value of combined neutrophil to lymphocyte ratio (NLR) and C reactive protein (CRP) for the efficacy of third generation cephalosporins in treating pneumonia after intracerebral hemorrhage. A total of 162 patients were enrolled and divided into an effective group (n=89) and an ineffective group (n=73) based on treatment outcome. Baseline characteristics, NLR and CRP levels at initial treatment and at efficacy evaluation, and changes in neutrophil count were compared between groups. Multivariate logistic regression was used to identify independent predictors. Results showed that the effective group had significantly lower proportions of females and patients with GCS<11, as well as lower initial NLR (9.53 vs. 12.68), lower NLR at evaluation (6.76 vs. 11.59), and lower CRP at evaluation (13.96 vs. 45.56 mg/L) (all P<0.05). The change in neutrophil count was also significantly greater in the effective group (1.97 vs. −0.39×10⁹/L). Independent predictors included gender (OR=0.060), GCS score (OR=0.058), initial NLR (OR=0.158), evaluation NLR (OR=0.135), evaluation CRP (OR=0.171), and neutrophil count change (OR=14.323), with all P values significant. The predictive model achieved an AUC of 0.953, sensitivity of 87.3%, and specificity of 92.0%. In conclusion, comprehensive assessment of these factors offers substantial value for predicting treatment response, and future multicenter studies with larger samples are needed to confirm these findings.

KEYWORDS

Neutrophil-to-lymphocyte ratio; C-reactive protein; Third-generation cephalosporin; Pneumonia after intracerebral hemorrhage; Predictive value

CITE THIS PAPER

Jing Wang, Xian Wang, Yuan Yao, Xiong Yang, Zhansheng Zhu. Predictive Value of Combined NLR and CRP Detection for the Efficacy of Third-Generation Cephalosporins in Post-Intracerebral Hemorrhage Pneumonia: A Retrospective Study. MEDS Basic Medicine (2026). Vol. 4, No. 1, 87-96. DOI: http://dx.doi.org/10.23977/medbm.2026.040112.

REFERENCES

[1] Mendelow AD, Gregson BA, Rowan EN, et al. Early surgery versus initial conservative treatment in patients with spontaneous supratentorial lobar intracerebral haematomas (STICH II): a randomised trial[J]. Lancet, 2013, 382(9890):397-408. 
[2] Hannawi Y, Hannawi B, Rao CP, et al. Stroke-associated pneumonia: major advances and obstacles[J]. Cerebrovasc Dis, 2013;35(5):430-443. 
[3] Patel UK, Kodumuri N, Dave M, et al. Stroke-Associated Pneumonia: A Retrospective Study of Risk Factors and Outcomes[J]. Neurologist, 2020, 25(3):39-48.
[4] Wu MR, Chen YT, Li ZX, et al. Dysphagia screening and pneumonia after subarachnoid hemorrhage: Findings from the Chinese stroke center alliance[J]. CNS Neurosci Ther, 2022, 28(6):913-921. 
[5] Xue LY, Gaowa S, Wang W, et al. Ventilator-associated pneumonia in patients with cerebral hemorrhage: Impact on mortality and microbiological characterization[J]. Med Clin (Barc), 2020, 154(10):400-405. 
[6] Wilson RD. Mortality and cost of pneumonia after stroke for different risk groups[J]. J Stroke Cerebrovasc Dis, 2012, 21(1):61-67.
[7] Martino R, Foley N, Bhogal S, et al. Dysphagia after stroke: incidence, diagnosis, and pulmonary complications[J]. Stroke, 2005, 36(12):2756-2763.
[8] Kasuya Y, Hargett JL, Lenhardt R, et al. Ventilator-associated pneumonia in critically ill stroke patients: frequency, risk factors, and outcomes[J]. J Crit Care, 2011;26(3):273-279. 
[9] Chamorro Á, Meisel A, Planas AM, et al. The immunology of acute stroke[J]. Nat Rev Neurol, 2012, 8(7):401-410. 
[10] Djordjevic Z M , Folic M M , Jankovic S M .Distribution and antibiotic susceptibility of pathogens isolated from adults with hospital-acquired and ventilator-associated pneumonia in intensive care unit[J].J Infect Public Health, 2017:S187603411730028X.
[11] Yu T, Liu H, Liu Y, et al. Inflammatory response biomarkers nomogram for predicting pneumonia in patients with spontaneous intracerebral hemorrhage[J]. Front Neurol, 2023, 13:1084616. 
[12] Turgunova L, Mekhantseva I, Akhmaltdinova L, et al. Association of sTREM-1 and Neutrophil-to-Lymphocyte Ratio as Prognostic Markers in COVID-19 Short- and Long-Term Mortality[J]. J Inflamm Res, 2023, 16:5807-5817. 
[13] Shi Y, Huang Y, Zhang TT, et al. Chinese guidelines for the diagnosis and treatment of hospital-acquired pneumonia and ventilator-associated pneumonia in adults (2018 Edition) [J]. J Thorac Dis, 2019,11(6):2581-2616. 
[14] Yan J, Zhai W, Li Z, et al. ICH-LR2S2: a new risk score for predicting stroke-associated pneumonia from spontaneous intracerebral hemorrhage[J]. J Transl Med, 2022, 20(1):193. 
[15] Adnet F, Baud F. Relation between Glasgow Coma Scale and aspiration pneumonia[J]. Lancet, 1996, 348(9020):123-124. 
[16] Zhu Y, Jia Y, Zhang C, et al. Clinical Characteristics and Prognosis of Patients with Severe Pneumonia with Neurological Dysfunction: A Regional Multicenter Retrospective Study in Mainland China[J]. Infect Drug Resist, 2025, 18:4215-4226. 
[17] López-de-Andrés A, Albaladejo-Vicente R, de Miguel-Diez J, et al. Gender differences in incidence and in-hospital outcomes of community-acquired, ventilator-associated and nonventilator hospital-acquired pneumonia in Spain[J]. Int J Clin Pract, 2021, 75(3):e13762.
[18] Wang X, Dai L, Zhang Y, et al. Gender and Low Albumin and Oxygen Levels are Risk Factors for Perioperative Pneumonia in Geriatric Hip Fracture Patients[J]. Clin Interv Aging, 2020, 15:419-424. 
[19] Barbagelata E, Cillóniz C, Dominedò C, et al. Gender differences in community-acquired pneumonia[J]. Minerva Med. 2020, 111(2):153-165. 
[20] Xu M, Wang J, Zhan C, et al. Association of follow-up neutrophil-to-lymphocyte ratio and systemic inflammation response index with stroke-associated pneumonia and functional outcomes in cerebral hemorrhage patients: a case-controlled study[J]. Int J Surg, 2024, 110(7):4014-4022. 
[21] Su J , Li Y , Tan S ,et al.Pretreatment neutrophil-to-lymphocyte ratio is associated with immunotherapy efficacy in patients with advanced cancer: a systematic review and meta-analysis[J].Scientific Reports, 15(1):1-17.
[22] Liu Qinlan, Li Wen, Lan Wenjuan. Predictive value of combined serum PCT, NLR, and CRP testing for therapeutic efficacy in children with mycoplasma pneumonia [J]. Heilongjiang Medicine, 2024,37(5):1160–1162.
[23] Ye Mengqiu. The value of combining PCT, LDH, IL-6, and NLR in the diagnosis and efficacy evaluation of bacterial bloodstream infections [J]. Modern Diagnosis & Treatment, 2024,35(14):2153–2155.

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