{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:02:13Z","timestamp":1791892933183,"version":"4.3.4"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the adjusted associations and incremental prognostic value of admission white blood cell count (WBC) and neutrophil\u2010to\u2010lymphocyte ratio (NLR) for unfavorable discharge outcome after spontaneous intracerebral hemorrhage (sICH).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Consecutive adults with CT\u2010confirmed sICH admitted to a tertiary academic hospital in northwestern China from August 2021 through August 2025 were retrospectively reviewed. After eligibility screening, 764 patients formed the study cohort. Admission WBC and log\n                      <jats:sub>2<\/jats:sub>\n                      \u2010transformed NLR were analyzed as continuous exposures; the primary outcome was discharge modified Rankin Scale (mRS) score \u2265\u00a03. Multivariable models were benchmarked against the ICH score and a clinical severity model. Internal validation used 1000 bootstrap resamples. A three\u2010level outcome\u2010derived WBC\u2010NLR burden classification was treated as exploratory and evaluated with 1000 nested bootstrap resamples.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The primary complete\u2010case analysis included 752 patients, of whom 358 (47.6%) had an unfavorable discharge outcome. Each 1 \u00d7 10\n                      <jats:sup>9<\/jats:sup>\n                      \/L increase in WBC was associated with higher odds of unfavorable outcome (adjusted odds ratio [OR], 1.116; 95% CI, 1.035\u20131.204;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.004), and each doubling of NLR was associated with an adjusted OR of 2.187 (95% CI, 1.687\u20132.835;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Adding WBC and NLR increased the ICH score AUC from 0.757 to 0.848 (\u0394AUC, 0.091;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001) and the clinical model AUC from 0.875 to 0.909 (\u0394AUC, 0.034;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). The optimism\u2010corrected AUC of the full model was 0.900, with a corrected calibration slope of 0.932 and Brier score of 0.129. The nested\u2010bootstrap\u2010corrected AUC was 0.776 for the exploratory burden\u2010only model and 0.899 after adding clinical covariates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Admission WBC and NLR remained associated with unfavorable discharge outcome after adjustment and improved discrimination beyond established severity measures. They may support preliminary short\u2010term risk assessment, whereas the outcome\u2010derived burden categories require external validation. The discharge endpoint should not be interpreted as a substitute for 90\u2010day functional outcome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.71786","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T11:17:43Z","timestamp":1791890263000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Admission White Blood Cell Count and Neutrophil\u2010to\u2010Lymphocyte Ratio for Early Risk Stratification after Spontaneous Intracerebral Hemorrhage: A Retrospective Cohort Study"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8484-0013","authenticated-orcid":false,"given":"Guangyan","family":"Li","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Lanzhou University Second Hospital  Lanzhou 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