Neutrophil-To-Lymphocyte Ratio Predicts 3-Month Outcome of Acute Ischemic Stroke

Abstract

Increasing evidences have demonstrated that inflammation is involved in the mechanisms of acute ischemic stroke (AIS). As an important and easy-to-measure inflammatory marker, neutrophil-to-lymphocyte ratio (NLR) shows a high association with mortality in patients with stroke in recent studies. In this study, we evaluated the prognostic role of NLR in patients with AIS. One hundred forty-three patients with AIS were enrolled. Clinical data were collected and the NLR was calculated from the admission blood work. The patients were followed up for 3 months after stroke onset. The occurrence of death and the major disability at 3 months after onset were end points in this study. Modified Rankin Scale score ≥3 was considered as poor outcome. In this study, 75 patients (52%) had poor outcome. We used binary logistic regression model to evaluate risk factor for poor outcome of AIS and found that the NLR was independently associated with the poor outcome of 3 months (P < 0.001). The optimal cutoff value for NLR as a predictor for 3-month outcome was 2.995. Therefore, in our study, high NLRs inversely predicted 3-month outcome in patients with AIS.

Neutrophil to Lymphocyte Ratio Predicts Short-Term Functional Outcome in Acute Ischemic Stroke

“…Furthermore, the NLR has been reported to be an independent risk factor for the incidence of AIS in generally healthy populations [2]. In our study, the NLR and the total WBC count were significantly higher in the poor outcome group than in the good outcome group, similar to results reported in other studies [23,24,[32][33][34]. This result remains significant even after adjustment for various potential confounders.…”

“…Lately, the NLR has been reported as an independent predictor of the severity and mortality of acute coronary syndrome [17][18][19][20][21][22][23]. Several studies have supported the hypothesis that the NLR is an independent factor for predicting short-term mortality and unfavorable functional outcome in AIS [23,24,32,34,41]. Tokgoz et al reported that the NLR at the time of hospital admission might be a predictor of short-term mortality independent of infarct volume in patients with AIS [42].…”

“…Recent studies have shown that the NLR provides a reliable inflammatory index that can be used for prognostic stratification in cardiovascular events [17][18][19][20][21][22][23]. However, the effects of the NLR on short-term functional outcome in AIS are still uncertain and few studies have been conducted [24].…”

The prediction of neutrophil to lymphocyte ratio for outcomes in ischemic stroke

“…A total of 8 studies [4,[17][18][19][20][21][22][23] of 3855 patients were included and the study characteristics of were listed in Table 1. All studies (2 prospective and 6 retrospective) were published between 2013 and 2017 with mean age from 62 to 70 years.…”

“…In addition, it is used to predict the prognosis of patients with various cancers [10,11], cardiovascular diseases [12,13] and hemorrhagic stroke [14][15][16]. Recently, NLR was used to predict in-hospital mortality [17,18], 90-day mortality [19][20][21] and 90-day poor outcomes (mRS≥3) [4,[21][22][23] in patients with ischemic stroke.…”