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Summary   Aims  To examine whether early rise of neutrophil‐to‐lymphocyte ratio ( NLR ) after patient hospitalization correlates with 30‐day mortality in patients with spontaneous intracerebral hemorrhage ( ICH ).    Methods  This retrospective study included all patients receiving treatment for spontaneous  ICH  between January 2015 and September 2016 at the Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences in Shanghai, China.  NLR  was determined at admission (T1), at 24‐48 hours (T2) and 5‐7 days (T3).  NLR  and clinicopathologic features were compared between those who survived for >30 days vs not. Multivariate regression was used to identify risk factors for 30‐day mortality.    Results  A total of 275 subjects were included in the analysis: 235 survived for at least 30 days; the remaining 40 subjects died within 30 days. The patients who died within 30 days had higher  ICH  score, larger  ICH  volume, and lower  GCS  score (all  P  < 0.05). In comparison with the baseline ( NLR T   1 ),  NLR  at 24‐48 hours ( NLR T   2 ) and 5‐7 days ( NLR T   3 ) was significantly higher in patients who died within 30 days ( P  < 0.05), but not in patients surviving for >30 days. In the multivariate analysis, the 30‐day mortality was associated with both  NLR T   2  ( OR  1.112, 95% CI  1.032‐1.199,  P  = 0.006) and  NLR T   3  ( OR  1.163, 95% CI  1.067‐1.268,  P  = 0.001). Spearman correlation analysis showed that both  NLR T   2  and  NLR T   3  correlated inversely with  GCS  score and positively with  ICH  score and  ICH  volume at the baseline.    Conclusions  Early rise of  NLR  predicts 30‐day mortality in patients with spontaneous  ICH .

Early increase of neutrophil‐to‐lymphocyte ratio predicts 30‐day mortality in patients with spontaneous intracerebral hemorrhage