Predictive value of admission neutrophil/lymphocyte ratio in symptomatic intracranial hemorrhage after stroke thrombolysis

Ören, Oğuz; Haki, Cemile; Kaya, Halil; Yüksel, Melih

doi:10.1007/s10072-021-05326-8

Cited by 9 publications

(4 citation statements)

References 18 publications

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“…Although low LMR obtained within 24 hours of admission was associated intracerebral hemorrhage transformation in AIS patients [29]. NLR, LMR, and PLR at admission were not found to be related to sICH in AIS patients after receiving intravenous thrombolysis treatment in our study, and similar ndings had been reported in other studies [30]. The number of positive patients was small and not enough to produce signi cant statistical differences.…”

Section: Discussionsupporting

confidence: 86%

Values of Lymphocyte-Related Ratios in Predicting the Clinical Outcome of Acute Ischemic Stroke Patients Receiving Intravenous Thrombolysis Based on Different Etiologies

Li,

Chen,

Wang

et al. 2024

Preprint

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Background Previous studies confirmed that neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), and platelet to lymphocyte ratio (PLR) were related to the clinical outcomes of acute ischemic stroke (AIS). This study aimed to explore predictive values of these ratios on the clinical outcomes of AIS patients receiving intravenous thrombolysis based on TOAST (Trail of Org 10172 in Acute Stroke Treatment) classification. Methods Patients admitted to department of Neurology with AIS were included. NLR, LMR and PLR were obtained before thrombolysis. Unfavorable functional outcome was defined as a modified Rankin score (mRS) of 3–6 at 90 days after onset. The Receiver Operating Characteristic (ROC) curves were used to explore the predictive values of lymphocyte-related ratios for clinical outcomes after receiving intravenous thrombolysis for different etiologies of AIS. Results A total of 381 patients were included. NLR was independently associated with unfavorable functional outcome for large-artery atherosclerosis stroke (aOR,1.354; 95% CI, 1.142–1.606; P = 0.001), small-artery occlusion stroke (aOR,1.505; 95% CI, 1.081–2.096; P = 0.015), and cardioembolism stroke (aOR,1.817; 95% CI, 1.065–3.101; P = 0.028). LMR was independently associated with poor functional outcome for large-artery atherosclerosis stroke (aOR, 0.693; 95% CI, 0.541–0.886; P = 0.004). NLR's AUC values for predicting poor functional outcome in large-artery atherosclerosis, small-artery occlusion and cardioembolism were 0.702, 0.750, and 0.697 respectively, with cutoff values of 3.193, 3.937, and 3.172. Conclusions NLR had good predictive ability for poor functional outcome of patients with large-artery atherosclerosis and small-artery occlusion strokes who received intravenous thrombolysis treatment, rather than other subtypes. LMR and PLR had no predictive values.

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Section: Discussionsupporting

confidence: 86%

Values of Lymphocyte-Related Ratios in Predicting the Clinical Outcome of Acute Ischemic Stroke Patients Receiving Intravenous Thrombolysis Based on Different Etiologies

Li,

Chen,

Wang

et al. 2024

Preprint

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“…Our study did not find associations between HT and several serum biochemical parameters previously reported in other studies, including ALB [58], uric acid [59], serum calcium [60], homocysteine [61], serum magnesium [62], AKP [63], RBC distribution width [64], neutrophils [65], lymphocytes [66], TBA [67], AST, or ALT [68]. For the four predictive models, while there were slight differences in their AUCs, none of these differences showed statistical significance.…”

Section: Discussioncontrasting

confidence: 74%

Predicting haemorrhagic transformation through serum biochemical indices for patients after endovascular treatment: a retrospective study

Wu,

Zhou

et al. 2024

Neurol Neurochir Pol.

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Introduction.The aim of this study was to determine the serum biochemical markers that can predict the risk of haemorrhagic transformation (HT) before and after endovascular treatment (EVT). Material and methods.This study included patients with anterior circulation large vessel occlusion (ACLVO) who underwent EVT within six hours of symptom onset between September 2017 and September 2022. These patients were retrospectively categorised into two groups: an HT group and a No-HT group.Results. A total of 180 patients were included in the study, of whom 55 (30.6%) had HT. The monocyte count before EVT (p = = 0.005, OR = 0.694, 95% CI 0.536-0.898), the activated partial thromboplastin time before EVT (p = 0.009, OR = 0.186, 95% CI 0.699-0.952), and the eosinophil count after EVT (p = 0.038, OR = 0.001, 95% CI 0.000-0.018) were all found to be independent predictors of HT, with warning values of 6.65%, 22.95 seconds, and 0.035*10^9/L, respectively. When compared to prediction using only demographic data [AUC = 0.662,95% CI (0.545, 0.780)], adding biochemical indices before EVT [AUC = 0.719,95% CI (0.617, 0.821)], adding biochemical indices after EVT [AUC = 0.670,95% CI (0.566, 0.773)], and adding both [AUC = 0.778,95% CI (0.686, 0.870)], the prediction efficiency of HT was improved among all three combinations, with no statistical significance.Conclusions. The levels of serum biochemical markers were found to show significant changes before and after EVT in ACLVO patients. A combination of demographic data and serum biochemical markers proved to be effective in predicting the occurrence of HT in patients with ACLVO who underwent EVT.

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“…Previous retrospective cohort studies have shown that higher levels of admission or post-treatment NLR are associated with hemorrhagic transformation (HT) ( 15 , 16 ), symptomatic intracerebral hemorrhage (sICH) ( 17 – 20 ), 3-month poor functional outcome (PFO) ( 17 , 19 , 21 , 22 ), and mortality at 3 months ( 18 , 19 , 22 ) in patients with AIS treated with reperfusion therapy. Nevertheless, there is still no full understanding of the association between the dynamic NLR and clinical outcomes in patients with AIS treated with reperfusion therapy, owing to methodological limitations.…”

Section: Introductionmentioning

confidence: 99%

Prognostic role of dynamic neutrophil-to-lymphocyte ratio in acute ischemic stroke after reperfusion therapy: A meta-analysis

Wu¹,

Fang²,

Sun³

et al. 2023

Front. Neurol.

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BackgroundThe prognostic role of the neutrophil-to-lymphocyte ratio (NLR), an inflammatory marker, in acute ischemic stroke (AIS) after reperfusion therapy remains controversial. Therefore, this meta-analysis sought to assess the correlation between the dynamic NLR and the clinical outcomes of patients with AIS after reperfusion therapy.MethodsPubMed, Web of Science, and Embase databases were searched to identify relevant literature from their inception to 27 October 2022. The clinical outcomes of interest included poor functional outcome (PFO) at 3 months, symptomatic intracerebral hemorrhage (sICH), and 3-month mortality. The NLR on admission (pre-treatment) and post-treatment was collected. The PFO was defined as a modified Rankin scale (mRS) of >2.ResultsA total of 17,232 patients in 52 studies were included in the meta-analysis. The admission NLR was higher in the 3-month PFO (standardized mean difference [SMD] = 0.46, 95% confidence interval [CI] = 0.35–0.57), sICH (SMD = 0.57, 95% CI = 0.30–0.85), and mortality at 3 months (SMD = 0.60, 95% CI = 0.34–0.87). An elevated admission NLR was associated with an increased risk of 3-month PFO (odds ratio [OR] = 1.13, 95% CI = 1.09–1.17), sICH (OR = 1.11, 95% CI = 1.06–1.16), and mortality at 3 months (OR = 1.13, 95% CI = 1.07–1.20). The post-treatment NLR was significantly higher in the 3-month PFO (SMD = 0.80, 95% CI = 0.62–0.99), sICH (SMD = 1.54, 95% CI = 0.97–2.10), and mortality at 3 months (SMD = 1.00, 95% CI = 0.31–1.69). An elevated post-treatment NLR was significantly associated with an increased risk of 3-month PFO (OR = 1.25, 95% CI = 1.16–1.35), sICH (OR = 1.14, 95% CI = 1.01–1.29), and mortality at 3 months (OR = 1.28, 95% CI = 1.09–1.50).ConclusionThe admission and post-treatment NLR can be used as cost-effective and easily available biomarkers to predict the 3-month PFO, sICH, and mortality at 3 months in patients with AIS treated with reperfusion therapy. The post-treatment NLR provides better predictive power than the admission NLR.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022366394.

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Predictive value of admission neutrophil/lymphocyte ratio in symptomatic intracranial hemorrhage after stroke thrombolysis

Cited by 9 publications

References 18 publications

Values of Lymphocyte-Related Ratios in Predicting the Clinical Outcome of Acute Ischemic Stroke Patients Receiving Intravenous Thrombolysis Based on Different Etiologies

Values of Lymphocyte-Related Ratios in Predicting the Clinical Outcome of Acute Ischemic Stroke Patients Receiving Intravenous Thrombolysis Based on Different Etiologies

Predicting haemorrhagic transformation through serum biochemical indices for patients after endovascular treatment: a retrospective study

Prognostic role of dynamic neutrophil-to-lymphocyte ratio in acute ischemic stroke after reperfusion therapy: A meta-analysis

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