Prognostic role of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic immune inflammation index in acute ischemic stroke

Abstract

The acute ischemic stroke (AIS) is a devastating disease and remains the leading cause of death and disability. This study aims to evaluate the role of hematological inflammatory markers (neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], and systemic immune inflammation index [SII]) in predicting the neurological recovery in acute cerebrovascular events over 1-year follow-up. Adult patients diagnosed with AIS within 3 hours from January 2016 to December 2018 were recruited retrospectively. The modified Rankin Scale (mRS) was recorded upon admission to the emergency department (ED) and 1, 3, 6, and 12 months after a stroke. The primary outcome measure was the neurological recovery. The neurological recovery was defined as an improvement in mRS score ≥ 1 compared with that at the ED admission baseline. A total of 277 consecutive adult patients with AIS within 3 hours were enrolled. The initial average of the National Institute of Health Stroke Scale was 9.2 ± 7.8, and 90.3% of patients had an mRS ≥ 2 at ED admission baseline. The overall neurological recovery rates of 48.7%, 53.7%, 59.2%, and 55.9% were observed at 1, 3, 6, and 12 months follow-up, respectively. The multivariate analysis revealed that the baseline NLR value was a significant predictor of neurological recovery at 3 months after a stroke (adjusted odds ratio = 0.89, 95% confidence interval = 0.80–0.99, P = .035). A low NLR at ED admission could be useful marker for predicting neurological recovery at 3 months after stroke.

Platelet-to-Lymphocyte Ratio as an Independent Factor Was Associated With the Severity of Ankylosing Spondylitis

“…Previous studies demonstrated that the complete blood count parameters and the ratio between them might act as markers for prognosis, status, and progression of diseases (20,21). PLR was reported to be closely related to the progression and prognosis of acute ischemic stroke, knee osteoarthritis, and papilledema due to idiopathic intracranial hypertension (22,23). AS is a chronic inflammatory autoimmune disease, and we aimed to determine the relationship between AS and PLR.…”

Assessing the relationship between systemic immune-inflammation index and mortality in patients with hypertrophic cardiomyopathy

“…Previous studies have shown that SII is a potential indicator for clinical endpoints for patients with coronary artery disease (13,14). The same was found in patients with hypertension (15), acute ischemic stroke (17), and chronic HF (27). However, no previous study has discussed the predictive value of SII in HCM.…”

“…Also, several studies indicated that markers of inflammation predicted adverse outcomes in HCM, such as high-sensitivity C reactive protein (CRP) ( 7 ), monocyte to high density lipoprotein cholesterol ratio (M/HDL-C) ( 8 ), and neutrophil to lymphocyte ratio (NLR) ( 10 ). A novel immune and inflammation index, namely, systemic immune-inflammation index (SII), which is calculated from platelet, neutrophil, and lymphocyte counts, has been examined as a prognostic factor for clinical outcomes in cancer patients ( 11 – 12 ) and in patients with cardiovascular diseases, such as coronary artery disease ( 13 – 14 ), hypertension ( 15 ), pulmonary embolism ( 16 ), and acute ischemic stroke ( 17 ). However, to date, the predictive ability of SII for mortality has not been reported in HCM.…”

Acute Inflammation in Cerebrovascular Disease: A Critical Reappraisal with Focus on Human Studies

“…In stroke, a retrospective study showed no difference in SII values upon admission between acute IS patients with neurological recovery and acute IS patients with no improvement at 1, 3, 6, and 12 months poststroke [ 59 ]. Conversely, in patients with large artery occlusion, decreased SII was associated with favorable clinical outcomes after MT [ 60 ].…”