Admission blood cell counts are predictive of stroke-associated infection in acute ischemic stroke patients treated with endovascular therapy

Deng, Qiwen; Gong, Pei; Chen, Xiangliang; Liu, Yukai; Jiang, Teng; Zhou, Feng; Hou, Jiankang; Lü, Min; Zhao, Hong-Dong; Zhang, Yuqiao; Wang, Wei; Shen, Rui; Li, Shuo; Sun, Huiling; Chen, Nihong; Shi, Hongchao

doi:10.1007/s10072-020-04827-2

Cited by 16 publications

(27 citation statements)

References 42 publications

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“…Meanwhile, an increase in the peripheral neutrophil is associated with more severe stroke, larger infarct volume, and worse functional outcomes, all of which are strong risk factors for SAI ( 17 – 19 ). Currently, Deng et al ( 20 ) demonstrated that elevated neutrophil was independently associated with increased risk of SAI in AIS patients treated with endovascular therapy. In addition, a ROC curve analysis performed by Nam et al showed a high AUC value for neutrophils to predict stroke-associated pneumonia (SAP) ( 21 ).…”

Section: Discussionmentioning

confidence: 99%

High Neutrophil Percentage-To-Albumin Ratio Can Predict Occurrence of Stroke-Associated Infection

Zhang

Tian

et al. 2021

Front. Neurol.

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Purpose: Stroke-associated infection (SAI) is associated with adverse outcomes in patients with acute ischemic stroke (AIS). In this study, we aimed to evaluate the association between neutrophil percentage-to-albumin ratio (NPAR) and SAI occurrence in patients with AIS.Methods: We retrospectively analyzed all AIS patients who were admitted to the Neurology ward of The Second Hospital of Tianjin Medical University from November 2018 to October 2020. The relationship between NPAR and SAI was analyzed by multivariable analysis. The receiver operating characteristic (ROC) curve was used to compare the predicted value of albumin, neutrophil percentage, neutrophil-to-lymphocyte ratio (NLR), and NPAR.Results: We included 379 AIS patients out of which 51 (13.5%) developed SAI. The NPAR was independently associated with increased risk of SAI adjusting for confounders [adjusted odds ratio (aOR) = 10.52; 95% confidence interval (CI), 3.33–33.28; P <0.001]. The optimal cutoff value of NPAR for predicting SAI incidence was 1.64, with sensitivity and specificity of 90.2 and 55.8%, respectively. The area under the curve (AUC) value of NPAR [0.771 (0.725–0.812)] was higher than that of albumin [0.640 (0.590–0.689)], neutrophil percentage [0.747 (0.700–0.790)], and NLR [0.736 (0.689–0.780)], though the statistical significance appeared only between NPAR and albumin.Conclusions: We demonstrated that a higher NPAR could predict the occurrence of SAI. Thus, NPAR might be a more effective biomarker to predict SAI compared with albumin, neutrophil percentage, and NLR.

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Section: Discussionmentioning

confidence: 99%

High Neutrophil Percentage-To-Albumin Ratio Can Predict Occurrence of Stroke-Associated Infection

Zhang

Tian

et al. 2021

Front. Neurol.

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“… 3 , 4 Our previous study presented a much higher frequency of stroke-associated infection (65.8%) in patients treated with endovascular therapy. 16 This discrepancy may be attributed to the inclusion of different definitions about infection and higher baseline NIHSS in patients undergoing endovascular therapy. The results of our study also revealed that patients with SAP had elevated levels of Hs-CRP, leucocyte, and a higher proportion of dysphagia as well as higher baseline NIHSS, which were consistent with previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…During the pathogenesis and progression of brain ischemic, neuroinflammation may be extraordinarily critical. 6 , 7 , 18 Several inflammatory biomarkers were evaluated in our previous studies, 15 , 16 suggesting that inflammatory biomarkers could be considered as prognosticators and indicators in ischemic stroke. In recent years, YKL-40, a novel biomarker of inflammation, has attracted attention as a valuable tool to predict diseases that are characterized by inflammation, fibrosis and tissue remodeling.…”

Section: Discussionmentioning

confidence: 99%

The Relationship Between Serum YKL-40 Levels on Admission and Stroke-Associated Pneumonia in Patients with Acute Ischemic Stroke

Shi

Chen

Gong

et al. 2021

JIR

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Background Stroke-associated pneumonia (SAP) is a standout complication after acute ischemic stroke (AIS), with a prevalence of 7–38%. The aim of this prospective study was to investigate the relationship between serum YKL-40 levels at admission and SAP. Methods Between August 2020 and February 2021, consecutive AIS patients from two centers were enrolled prospectively. Serum YKL-40 concentrations were measured via enzyme-linked immunosorbent assay. We performed logistic regression analyses to explore the relationship between YKL-40 and SAP. Receiver operating characteristic curve was also used to assess the predictive ability of YKL-40 in predicting SAP. Results Ultimately, a total of 511 AIS patients were recruited. Multivariate logistic regression analysis showed that YKL-40 was independently related to SAP, whether as a continuous variable or as quartiles ( P =0.001). The area under curve of YKL-40 to predict SAP was 0.765. The optimal cutoff value of YKL-40 as a predictor of SAP was determined to be 206.4 ng/mL, where the sensitivity was 63.1% and the specificity was 82.0%. Conclusion Our study demonstrated that YKL-40 might be considered as a useful biomarker to predict SAP in AIS patients.

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“…NLR, PLR and LMR may have the ability to predict functional outcome in AIS patients treated with intravenous thrombolysis [17][18][19]. Our previous research manifested that NLR and PLR might be connected with stroke-associated infection after endovascular treatment [20]. Goyal and colleagues found NLR on admission may be able to function as a prognostic biomarker of outcomes in patients with large vessel occlusion stroke [21].…”

Section: Introductionmentioning

confidence: 96%

The Association of Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio and Lymphocyte-Monocyte Ratio With Post-Thrombolysis Early Neurological Outcomes in Patients With Acute Ischemic Stroke

Gong

Liu

Gong

et al. 2020

Preprint

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Background and Purpose: To investigate the association of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and lymphocyte-monocyte ratio (LMR) with post-thrombolysis early neurological outcomes including early neurological improvement (ENI) and early neurological deterioration (END) in patients with acute ischemic stroke (AIS).Methods: AIS patients undergoing intravenous thrombolysis were enrolled from April 2016 to September 2019. Blood cell counts were sampled before thrombolysis. Post-thrombolysis END was defined as National Institutes of Health Stroke Scale (NIHSS) score increase of ≥4 within 24 hours after thrombolysis. Post-thrombolysis ENI was defined as NIHSS score decrease of ≥4 or complete recovery within 24 hours. Multivariable logistic regression analyses were performed to explore the relationship of NLR, PLR and LMR to post-thrombolysis END and ENI. We also used receiver operating characteristic curve analysis to assess the discriminative ability of three ratios in predicting END and ENI.Results: Among 1060 recruited patients, a total of 193 (18.2%) were diagnosed with ENI and 398 (37.5%) were diagnosed with END. Multivariable logistic models indicated that NLR (odds ratio [OR], 1.652; 95% confidence interval [CI] 1.510-1.807, P=0.001) and PLR (OR, 1.015; 95% CI 1.012-1.018, P=0.001) were independent factors for post-thrombolysis END. Moreover, NLR (OR, 0.686; 95% CI 0.631-0.745, P=0.001), PLR (OR, 0.997; 95% CI 0.994-0.999, P=0.006) and LMR (OR, 1.170; 95% CI 1.043-1.313, P=0.008) served as independent factors for post-thrombolysis ENI. Area under curve (AUC) of NLR, PLR and LMR to discriminate END were 0.763, 0.703 and 0.551, respectively. AUC of NLR, PLR and LMR to discriminate ENI were 0.695, 0.530 and 0.547, respectively.Conclusions: NLR and PLR were associated with and may predict post-thrombolysis END. NLR, PLR and LMR were related to post-thrombolysis ENI.

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Admission blood cell counts are predictive of stroke-associated infection in acute ischemic stroke patients treated with endovascular therapy

Cited by 16 publications

References 42 publications

High Neutrophil Percentage-To-Albumin Ratio Can Predict Occurrence of Stroke-Associated Infection

High Neutrophil Percentage-To-Albumin Ratio Can Predict Occurrence of Stroke-Associated Infection

The Relationship Between Serum YKL-40 Levels on Admission and Stroke-Associated Pneumonia in Patients with Acute Ischemic Stroke

The Association of Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio and Lymphocyte-Monocyte Ratio With Post-Thrombolysis Early Neurological Outcomes in Patients With Acute Ischemic Stroke

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