ABSTRACT
Background: Neutrophil-lymphocyte-ratio (NLR) and platelet-lymphocyte-ratio (PLR) have emerged as potential biomarkers in predicting the outcomes of aneurysmal subarachnoid hemorrhage (aSAH). Since a study was never conducted on the Southeast Asian and Indonesian population, we designed the present study to evaluate the potential of NLR and PLR in predicting cerebral infarction and functional outcomes and find the optimal cutoff value. Methods: We retrospectively reviewed patients admitted for aSAH in our hospital between 2017 and 2021. The diagnosis was made using a computed tomography (CT) scan or magnetic resonance imaging and CT angiography. Association between admission NLR and PLR and the outcomes were analyzed using a multivariable regression model. A receiver operating characteristic (ROC) analysis was done to identify the optimal cutoff value. A propensity score matching (PSM) was then carried out to reduce the imbalance between the two groups before comparison. Results: Sixty-three patients were included in the study. NLR was independently associated with cerebral infarction (odds ratio, OR 1.197 [95% confidence interval, CI 1.027-1.395] per 1-point increment; P = 0.021) and poor discharge functional outcome (OR 1.175 [95% CI 1.036-1.334] per 1-point increment; P = 0.012). PLR did not significantly correlate with the outcomes. ROC analysis identified 7.09 as the cutoff for cerebral infarction and 7.50 for discharge functional outcome. Dichotomizing and performing PSM revealed that patients with NLR above the identified cutoff value significantly had more cerebral infarction and poor discharge functional outcome. Conclusion: NLR demonstrated a good prognostic capability in Indonesian aSAH patients. More studies should be conducted to find the optimal cutoff value for each population.
ABSTRACT
Background The preventive measure of Coronavirus Disease pandemic, such as nationwide lockdown, might lead to stress, depression, and anxiety, prominently in adolescents. Many factors were indicated to influence its severity. This study aimed to investigate the magnitude of COVID-19-related mental health problems in adolescents and the associated factors. Methods This cross-sectional study gathered 2018 adolescents throughout Indonesia from April 22nd-28th 2020. The questionnaire was spread through social media and included Kessler-10 Psychological Distress scale and closed-ended questions about the risk and protective factors. The results were analyzed using Mann-Whitney U test, Kruskal-Wallis test, and Logistic Regression. Results The participants were mostly males (91.8%) with a median age of 19. The results showed 54.1% experienced varying degrees of distress. All variables were significantly related with psychological distress during Mann-Whitney-U and Kruskal-Wallis test. The logistic regression analysis showed maintaining or improving dietary pattern and sleep quality was found to be protective against psychological distress (OR = 0.497,95%CI = 0.34-0.725 and OR = 0.515,95%CI = 0.372-0.714, respectively), while others were risk factors, i.e.: Not having a confidant (OR = 1.539,95%CI = 1.226-1.931), frequent argument with parents (OR = 1.735,95%CI = 1.343-2.24), feeling worried (OR = 2.364, 95%CI1.528-3.656), chronic diseases (OR = 2.601,95%CI = 1.468-4.606), and mental illnesses (OR = 9.866,95%CI = 3.855-25.249). Conclusion More than half of adolescents experienced distress. The findings called for initiatives by experts in providing psychosocial support for adolescents.
