Can albumine to INR ratio predict prognosis in patients with subarachnoid hemorrhage

Aneurysmal subarachnoid hemorrhage (aSAH) is among the neurovascular diseases requiring urgent intervention, characterized by high rates of mortality and morbidity. Systemic inflammatory response and coagulation disorders play a critical role in the prognosis of aSAH patients. This study investigates the prognostic and diagnostic value of the albumin-International Normalized Ratio (INR) ratio (AIR) in predicting 28-day mortality in aSAH patients. This retrospective, single-center study included 71 adult patients diagnosed with aSAH, confirmed through imaging modalities. Demographic, clinical, and laboratory data of the patients (albumin, INR, neutrophil count, and other inflammatory indices) were analyzed. The primary endpoint was determined as 28-day mortality. ROC analysis was performed to evaluate the diagnostic performance of the AIR and other indices. The 28-day mortality rate was found to be 39.4% (n=28). In patients who developed mortality, median AIR values and albumin levels were significantly lower (p<0.001), while INR and neutrophil counts were significantly higher (p<0.001). AIR demonstrated superior performance compared to other indices in predicting 28-day mortality, with a sensitivity of 89.3% and an area under the curve (AUC) of 0.839. Multivariable logistic regression analysis confirmed AIR as an independent predictor of mortality. This study revealed that AIR is a reliable and practical prognostic biomarker for predicting short-term mortality in aSAH patients. AIR outperformed other inflammatory and coagulation markers. Considering its ease of calculation and clinical applicability, AIR could serve as a valuable tool for patient risk stratification and management.