Association Between Neutrophil-to-Lymphocyte Ratio/Lymphocyte-to-Monocyte Ratio and In-Hospital Clinical Outcomes in Ischemic Stroke Treated with Intravenous Thrombolysis

• Main Authors: Li G (Author), Hao Y (Author), Wang C (Author), Wang S (Author), Xiong Y (Author), Zhao X (Author)
• Format: Book
• Published: Dove Medical Press, 2022-09-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Guangshuo Li,1 Yahui Hao,2 Chuanying Wang,1 Shang Wang,1,2 Yunyun Xiong1- 3&ast;, Xingquan Zhao1 &#x002A1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China; 2China National Clinical Research Center for Neurological Diseases, Beijing, People's Republic of China; 3Chinese Institute of Brain Research, Beijing, People's Republic of China&ast;These authors contributed equally to this workCorrespondence: Yunyun Xiong, China National Clinical Research Center for Neurological Diseases, Beijing, People's Republic of China, Email [e-mail] Xingquan Zhao, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 Nansihuanxilu, Fengtai District, Beijing, 100070, People's Republic of China, Email [e-mail]: Investigations on neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) in patients with ischemic stroke are insufficient. We aimed to investigate the relationship of NLR and LMR with in-hospital clinical outcomes at different time points in ischemic stroke patients treated with intravenous tissues plasminogen activator (IV tPA).Methods: We retrospectively enrolled patients who received IV tPA therapy within 4.5 hours from symptoms onset. Demographics, clinical characteristics, imaging measures, and the in-hospital clinical outcomes including early neurological improvement (ENI, defined as NIHSS score reduction within 24 hours ≥ 4 points or decreased to the baseline) and favorable functional outcome (defined as modified Rankin scale 0- 1) were collected. Multivariable logistic regression analyses were performed to test whether NLR or LMR was an independent predictor for the in-hospital clinical outcomes.Results: One hundred and two patients treated with IV tPA were included. NLR at 24 hours proved to be an independent predictor of ENI (adjusted OR=0.85, 95% CI=0.75- 0.95, P=0.04). NLR at 48 hours and LMR at 48 hours proved to be independent predictors of mRS 0- 1 at discharge (NLR at 48 hours: adjusted OR=0.64, 95% CI=0.49- 0.83, P=0.01; LMR at 48 hours: adjusted OR=1.50, 95% CI=1.08- 2.09, P=0.02). The AUC of NLR at 48 hours to predict favorable functional outcome at discharge was 0.79 (95% CI=0.70- 0.88, P< 0.001) and the optimal cut-off was 5.69 (sensitivity=0.52, specificity=0.63).Conclusion: In our study, NLR at 24 hours was correlated with ENI. Both NLR and LMR at 48 hours were closely associated with favorable functional outcomes at discharge.Keywords: stroke, thrombolysis, tissue plasminogen activator, neutrophil, inflammation

Item Description

1178-7031